I placed this implant 4 months ago, patient is a heavy smoker and even tough she was instructed to quit she did not, she came back for second stage and presents bone loss, my question is, should I rehabilitate this implant as it is? or what should I do? thanks in advance for your recommendations
do you have a PA at the time of implant placement? you can still restore it. if implant is stable. just pt probably will see the implant and collar of the abutment.
I honestly don’t think that you have a problem. Judging by the nature of the site and the fact that the fixture is placed between 2x tilted teeth I think that degree of remodeling is to be expected… the soft tissue profile on the x-ray looks consistent and at the end of the day this should be fine.
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I have had cases like this, it survive about 4 years
Is that biohorizons laser-lok?
Hi, it’s Ritter implant
Notice that the first x-ray you took, showed the threads clearly on both sides of the implant. The second you sent, didn’t. That means you can count on the bone level on the first on as you are 7 degrees within perpendicular. The second really doesn’t tell an accurate story.
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I have a question. Did you place this implant flapless? Bc from PA taken at surgery, it looks like the implant wasn’t fully in bone to me.
This was my first implant, you are right it was not completely into bone, by lack of experience I did not prepare the osteotomy larger than my implant because I did not know at the moment that I was supposed to do that and the implant did not went all the way into subcrestal. I uploaded another image at the time of placement
i thought so. then your implant position pre op and post op matches. you can still restore but the problem is any recession and your patient might see the implant. also i usually try to place the implant parallel w/ the tooth anterior to the implant instead of parallel to the distal tooth. its ok. after we learn the basic of implant placement, the rest is experience.
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@dg36 this result may not necessarily have been a problem of depth placement per se. If the ridge is thin at the crest, even if you place the implant at “bone level” according to your vision, the remodeling process following surgery can result in crestal bone resorption and show this result. Was the ridge very thin at the crest when you placed the implant?
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no the ridge was not thin, I used a 4.2 X 11.5 implant, the problem was mine, I feel really bad about that and I realized now I should have remove the fixture an drill deeper 