Hello everyone. I am new to Implant Dentistry! Have placed 4.5×11.5 implant in lower molar region 1 month back. Today during following up xray I have seen bone loss in the mesial side of the implant. Moreover the cover screw is visible a little bit inside the mouth, i.e. soft tissue healing is still not completed! There is no pain, swelling or any other difficulties. I have prescribed Mouthwash and antiseptic Gel to apply over the soft tissue around the implant area. Is this normal? How to proceed further? Kindly guide!
While it would have been better to place the fixture 1-2mm deeper in order to take advantage of the “Zero bone loss” concept provided by the built in conical connection I think what you are seeing here is simply radiographic distortion via angulation of the beam. I would be more concerned about the depth of placement and the negative effect it is going to have on the final emergence profile than I would be the appearance of radiographic bone loss
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1-2mm of bone loss is normal for implants overtime. like you i would worry when i see bone loss on follow up PA. could be just PA discrepancy. however there could be real bone loss as well. at this stage nothing more you can do then to wait for integration and continue with implant treatment. mesial bone loss is not detrimental or catastrophic enough for me to consider or advise implant removal.
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What happend here is your flap closure is not tension free, so on first day your suture is opened and bacteria start to grow in mesial area and cause bone loss, thats why after 1 month you see the cover screw exposed partially, when im new to implant world this also happend to me, usually it will survive for a couple years
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Thank you so much Doctors for your replies. Your suggestions will definitely help me in my future implant cases.