1. #1

    Default Cosmetic Alteration Options to Previously Completed Work

    I was the victim of violent crime some 10 years ago where I21 and 22 were knocked out, taking much of the surrounding gum tissue and bone with them and I 11 was cracked in half. I received treatment at the Leeds Dental Institute back in 2001 where they placed two implants, abutments and crowns in and cemented then veneered I11.

    It was decided by the surgeons at the time, due to the large amount of discharging bone fragments, that to risk a gum graft was not sensible. Therefore I currently have a slight lack of gum surrounding I21 / 22.

    I am not happy with the positioning or visibility of the crowns today. Recent x-rays show that the implants are perfectly healthy with no further receeding of the surrounding tissue or bone.

    I am interested in understanding the process for replacing both crowns and the veneer to more aesthetically pleasing versions, combined with a tooth whitening process.

    At the same time I would like to specifically understand how a gum graft can be factored into this proceedure and what the inherent risks are today and the likely costs of such treatments.

    I look forward to hearing back from you soon.


  2. #2
    davidbloom's Avatar
    Join Date
    Sep 2009


    Dear Joe

    Having read your email but not having seen you in person I can answer
    this question in general terms but the actual situation may differ in
    some aspects. I think there is some good news and bad news. First the
    bad news which relates to the gum position. Once an implant is
    integrated into the bone it is generally not possible to just add gum
    via a graft as this gum would need some extra bone to support it. The
    only way to achieve this now would be to remove the implants, graft bone
    into the site, wait for this to heal and then place new implants into
    the site - the new bone could then support the gum in a better aesthetic

    The good news is that other aesthetic changes such as crown position,
    shape and colour are easier to change by a combination of first
    whitening the remaining teeth if required and then taking impressions
    for new implant posts to change the angulation of the implant crowns and
    also making new crowns. It may be possible to use some pink porcelain to
    help hide the lack of gum to improve the appearance somewhat. Any other
    restorations on teeth can be changed (such as the veneer) if required at
    this time and even more veneers can be added if appropriate .

    It would not be possible at this stage to quote fees but this should be
    discussed at any examination stage .
    Dr David Bloom BDS

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