Loose cement retained crown?

I try to use screw retained crown but after a remake, the lab decided to make a cement retained crown. My patient really wanted the crown cemented, and it finally fit, so we cemented it. I made sure I did not use a lot of cement to avoid any cement near the actual implant.

1 month later, during a recall, I noticed the implant crown was very loose! on the BW it still sits fine.
Should I use a Richwil gummy to remove the crown from the abutment and tighten it? Should I wait until it works itself out?

If I drill a hole through the crown and access the abutment to unscrew it, how to do get the crown off the abutment?

Any opinions on what I should do?

Thank you

I’ve had this happen to me.It may or may not loosen more and it may be locked in under the contacts.If it does not come out on its own, You will unfortunately have to bite the bullet in this case and section the crown carefully and remove it.
You’ll have to insist that Your lab remakes a new screw retained crown and hopefully will give you credit for the first one.

I actually think that you have another issue in that this does not appear to be the proper abutment. Based on the limited view it appears to be a 3i fixture, or at least a clone of one. Regardless of the brand it appears to be a mismatch so my first thought would be to check with the lab and verify that the proper parts were used… it just doesn’t look like an intimate fit. When it comes time to remove this crown you should easily be able to access it through the occlusal just as though it is an endo access and sectioning the crown should be last resort. In essence you should be able to convert this cement retained restoration into a screw retained or screwmented. I think you have a mismatched abutment though…

Do you think I can drill through the occlusal and create a “screw-retained”. The access hole is covered with teflon tape/composite. I was hoping to do this before diving right into sectioning. Thank you

@scotty I hope it is the right parts I wrote in big bold “use genuine parts” and it is a remake because the screw-retained they sent me did not fit in a previous visit. it is indeed a 3i… if it is a mismatched abutment, will it come loose again?

I used 3i for years and honestly never had a problem unless aftermarket parts were used. The problem with 3i is that it is very expensive and the desire to use aftermarket stuff is there, especially if you are using a large commercial lab. When I look at the image I don’t see any flat-flat contact at the implant abutment interface which strongly suggests an aftermarket component. The connection with 3i is excellent and if not for the fact that my referrals prefer Zimmer I would likely still be using it. Bottom line if it is indeed a 3i and you elect to remake it with genuine parts I would be shocked if you have any issues moving forward.

I have had this happen too. I accessed through the occlusal and re-cemeted the crown to the abutment and put it back together as a screwmentable system. If the crown is loose from the abutment and won’t separate by hand, the lab can heat it to decompose the cement and then sandblast it clean. That does assume the crown cemented to the abutment will draw in and out of the implant.