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Is a CT Scan Necessary for Dental Implants?

I’m getting a dental implant for an upper front tooth. Is a CT scan necessary? And should I be concerned about the implant brand my dentist uses? A friend says that I should ask. Which brands are the best? Thank you. Jamison from NJ



Thanks for your inquiry. CT scans and the quality of implant fixtures will affect the outcome of your implant surgery. And so will your dentist’s training. We will explain.

Dental Implants and CT Scans

Although many dentists skip CT scans for implants, many root forms poke holes in the nasal sinus. I CT skin can help prevent that. A CT scan also shows your bone volume, depth, and thickness to help your dentist decide if they can place the implant without grafting or sinus augmentation. Don’t skip the CT scan.

Should You Ask Your Dentist About Implant Brands?

Yes, ask your dentist which implant brands they use. The top dental implant manufacturers are Straumann and Nobel Biocare. 3i, BioHorizons, Zimmer, and Astrotech are reliable brands, too. Avoiding dental implant failure requires fixtures made by strict standards. The manufacturer’s quality control cannot be compromised. Avoid a dentist who uses cheap fixtures.

Look for a Trained Implant Dentist

Dental implant crown, abutment, and root formIf you want to be sure about your dentist’s concern for quality implants, choose one with advanced implant training.

Otherwise, your dental implants might seem successful, but four or five years later become loose. If a dentist must remove the loose implant, the surgical site will need bone grafting. Or you can begin to experience pain, nerve damage, infection, or other problems.

Don’t settle for anything less than a dentist who performs 3-D scans, uses high-quality implant fixtures, and doesn’t take any shortcuts.

Dr. Heng Lim, an Owasso, Oklahoma cosmetic dentist, sponsors this post. Dr. Lim completed advanced training in dental implant placement and restoration at Baylor College of Dentistry.


New Implant Bridge and My Teeth Are Misaligned

After getting a new implant bridge in November, my teeth on the left side do not line up. The bridge has two implants and replaces four bottom teeth. I think this is weird, but he says it’s better each time my dentist tries to adjust it. Maybe it looks better, but it doesn’t feel better. Is this a common issue? If so, who do I need to see to resolve it? I no longer value my dentist’s opinion. I’m frustrated and think that I deserve a refund. Thanks for your help. Marge from Rockford, IL


Thank you for your question. We are sorry to read about your disappointing experience with your implant bridge.

Dental implant bridge
Dental implant bridge

When you bite down, your upper and lower teeth should meet at the same time. Although the issue can occur, it is related to the quality of dental implants and the skill of the implant dentist. If the problem continues, it could lead to TMJ disorder.

What May Cause Misalignment in an Implant Bridge?

Sometimes, miscommunication can occur if an oral surgeon places the implants, but a dentist restores them with crowns or a bridge. If the surgeon places the implants in a location that the dentist did not anticipate, your crowns or bridge will not fit correctly, and it can misalign your bite. Symptoms can include teeth, jaw, neck, ear pain, and other jaw joint issues.

We recommend getting a second opinion from a skilled implant dentist. You will need an examination and a 3-D x-ray to determine whether the surgeon placed the implants incorrectly or whether there is an issue with the position or quality of the implant bridge.

Getting a second opinion promptly can prevent you from experiencing symptoms that will worsen with time. Also, you paid for a functional implant bridge, but your teeth are misaligned and interfering with bridge function. After getting a second opinion and evidence of your current dentist’s faulty work, you can ask for a refund.

Dr. Heng Lim, an Owasso, Oklahoma cosmetic dentist, sponsors this post.


It Still Hurts to Chew with My New Crown

Two months ago, I received three crowns on the bottom molar teeth. The right second molar still hurts when I chew. The pain feels like a radiating shock. I try not to chew on that side of my mouth, but it is so painful if I make a mistake and bite something slightly crunchy. My dentist adjusted my bite twice but now says the problem is that I chew too forcefully and should focus on lighter chewing. However, I disagree because I did not have the problem before getting the crowns. I am afraid of developing TMJ because of my tension and favoring the left side of my jaw. What could be causing the pain? Thanks. Dakota from Colorado Springs


Thank you for your question.

What Causes Pain When Chewing with a New Crown?

When you chew with a new crown is painful, two likely reasons are that your bite is too high or you have a tooth infection.

  • Bite too high – When a dentist seats your crown incorrectly, your opposing or upper teeth may hit the crown first and harder than other teeth when you chew. And that will increase sensitivity and pain in your tooth.
  • Tooth infection – An infection and inflamed tooth ligament can create a toothache. A ligament connects your tooth and jawbone, so you may feel pain when you chew. Advanced disease can cause the pain that you describe.

If your dentist tried to reduce your bite twice, your tooth is likely infected, and an x-ray will reveal it. Sometimes, tooth infection is subtle and requires a root canal specialist (endodontist). If your dentist cannot evaluate and diagnose the problem, ask for a referral to a root canal specialist.

And you are correct; delaying the problem can result in TMJ symptoms, including jaw, neck, and ear pain, headaches, and jaw stiffness. Please do not delay treatment.


Dr. Heng Lim, an Owasso, Oklahoma dentist, sponsors this post.