West Family Dentistry PC

[redacted] [redacted] *** [redacted] *** [redacted] [redacted] Response to complaint dated October 10, patient (client) [redacted] /> I saw the patient on 7/23/regarding the restoration of an implant previously placed by an oral surgeonOn this date I placed an impression analogue for a custom fabricated implant abutment and full coverage porcelain crownAlso at this time I took a periapical x-ray to ensure the abutment was fully engaged into the implantThis impression was sent to the dental labOn 8/14/attempted to seat the abutment and the full crownThe abutment screw is placed into the implant and torqued using a [redacted] specialty torque wrenchThe manufacturer's recommendation states the torque to be placed at psi, which I didUpon torquing it, I did hear an audible "pop", which is the way a torque wrench worksHowever, when I went to seat the crown, I noticed the abutment was looseI therefore took another x-ray, and noticed the screw was fractured inside the implant, a complete mechanical failure for the abutmentI have done literally hundreds of implant restorations in my practice the past 20+ yearsI have never, except in this one case, had an abutment screw failSince this time, I have placed numerous implants, the toque wrench worked fine, therefore my conclusion is a structural mechanical failure of the abutment screwI contacted the oral surgeon, who would attempt removal of the screwNeither he nor I was able to do thisThis resulted in the need for the implant to be removed, which It wasIt was removed by the oral surgeon at no charge, but a fee of $ was applied to cover the cost of a bone graftThe patient paid for this, and I reimbursed her two weeks later, therefore this surgery was done at no cost to the patientI have since talked to the oral surgeonHe has assured me he will place the new implant at no cost to the patientI will also place a new abutment and full crown at no costThe entire procedure will be zero cost for the new placement Also, on 8/14/took impressions to fabricate a treatment partial denture so my patient would not be partially edentulous as we awaited the new implant/abutment/crown therapy 5:55AM [redacted] Family Dentistry 307-875-page This cost was $She also had a root canal and a post/core build up on tooth #(upper right first molar) due to an abscessThe total cost of this was $On 9/3/t gave her a credit of $hence the interim partial denture, root canal and post/core were done at zero charge to the patient Once again, my patient will not be charged for the surgery and follow up restoration of the failed implant (tooth #12)I have, and will continue to stand by my workThank you for the opportunity to respond to this misunderstanding ** [redacted] ***

[redacted] 
[redacted] 
[redacted] 
[redacted] 
[redacted] 
Response to complaint dated October 10, 2014 patient (client) [redacted]. 
/>
I saw the patient on 7/23/14 regarding the restoration of an implant previously placed by 
an oral surgeon. On this date I placed an impression analogue for a custom fabricated implant 
abutment and full coverage porcelain crown. Also at this time I took a periapical x-ray to ensure the abutment was fully engaged into the implant. This impression was sent to the dental lab. On 8/14/141 attempted to seat the abutment and the full crown. The abutment screw is placed into the implant and torqued using a [redacted] specialty torque wrench. The manufacturer's 
recommendation states the torque to be placed at 30 psi, which I did. Upon torquing it, I did 
hear an audible "pop", which is the way a torque wrench works. However, when I went to seat 
the crown, I noticed the abutment was loose. I therefore took another x-ray, and noticed the 
screw was fractured inside the implant, a complete mechanical failure for the abutment. I have 
done literally hundreds of implant restorations in my practice the past 20+ years. I have never, 
except in this one case, had an abutment screw fail. Since this time, I have placed numerous 
implants, the toque wrench worked fine, therefore my conclusion is a structural mechanical 
failure of the abutment screw. I contacted the oral surgeon, who would attempt removal of the 
screw. Neither he nor I was able to do this. This resulted in the need for the implant to be 
removed, which It was. It was removed by the oral surgeon at no charge, but a fee of $455.00 
was applied to cover the cost of a bone graft. The patient paid for this, and I reimbursed her 
two weeks later, therefore this surgery was done at no cost to the patient. I have since talked to the oral surgeon. He has assured me he will place the new implant at no cost to the patient. I will also place a new abutment and full crown at no cost. The entire procedure will be zero cost for the new placement. 
Also, on 8/14/14 1 took impressions to fabricate a treatment partial denture so my patient 
would not be partially edentulous as we awaited the new implant/abutment/crown therapy. 
 
2014 5:55AM [redacted] Family Dentistry 307-875-3581 page 3
This cost was $475.00. She also had a root canal and a post/core build up on tooth #3 (upper
right first molar) due to an abscess. The total cost of this was $1125.00. On 9/3/14 t gave her a
credit of $1600.00 hence the interim partial denture, root canal and post/core were done at
zero charge to the patient.
Once again, my patient will not be charged for the surgery and follow up restoration of the
failed implant (tooth #12). I have, and will continue to stand by my work. Thank you for the
opportunity to respond to this misunderstanding.
**. [redacted]. [redacted]