Greetings,
I am at the end point of the surgical placement of two implants. Naturally,
insurance did not cover the cost. An abutment tooth under a 20+ year old
bridge had developed decay below the gum line. The periodontist stated that
by the time they cut off the old bridge, performed crown lengthening on the
decayed abutment tooth, restored the decayed tooth & then replaced the
3 -unit bridge, it would be more cost-effective to spend a little more money
& place implants to replace the extracted abutment tooth & the original
missing tooth that the bridge corrected. Naturally he advised that it did
not include the new crowns on the implants. Without considering the cost of
the crowns, I figured it was about $1000 more to get the two implants than
repair the decay & replace the bridge but it made sense to me because I did
not know the condition of both abutment teeth after all those years &
thought that after all that work, a new bridge may not be supportable or
have a very much shorter lifespan & I would be back in a few years for
implants anyway (I am 55 years old).
Crowns cost me ~$500 with insurance, so even after factoring in another
$1000 I agreed. I was never informed nor did I have any reason to know two
key facts. First, that my insurance covers crowns only over natural teeth. I
just assumed a crown over a prosthetic root would be even simpler & a crown
would be covered. Nowhere in my payment schedule is there an asterisk
stating that crowns are not covered when placed on top of an implant.
Second, that an implant crown without an abutment, is more expensive than a
normal crown.
Imagine my surprise when the dentist office called me before my crown
appointment to give me a price of $1400 per tooth for abutment & crown,
effective tripling the final additional cost that I was figuring. The lady
at dentist office even stated a different payment code for this type of
crown. She also stated that it was more invasive than a regular crown. I
must be really naive because I envisioned the dentist unscrewing the healing
cap, screwing in the appropriate size abutments, taking an impression, etc.,
etc. like a normal crown. Is that incorrect? If it is correct, would not
grinding down a diseased old tooth for 30 minutes considered more invasive
than selecting & screwing in an abutment?
My MAIN question is: what is it about an implant crown that makes it more
expensive than a normal crown over natural tooth? The breakdown was
something like $350 for the abutment & $1050 for the crown.
Also, I live in Phoenix. Is this price in line or am I subsidizing the
discount that I & others with dental insurance receive? I
Thanks for reading this long post.

Rich