4.0 by 10 implant
radiolucency present at the apex of implant causing swelling at the vestibule. I removed the implant, but what can cause this failure and infection at the apex? The top 60% the bone was solid but just at the tip had infection
attaching
day of implant placed
2 weeks after
3 weeks after
Looks like you just experienced your first implant failure and if you keep placing them you will see more… You most likely did nothing wrong and unlike “many” other folks out there I will not even fault you for placing a healing abutment the day of surgery as I have done that for at least 90-95% of all the implants I have placed over the past 20 years regardless of initial stability or lack there of. A lot of people will try to drag you through the weeds and point out a whole bunch of BS that might have caused this to fail but at the end of the day 4-7% of all implants will fail to integrate and another 20-30% will experience complications and/or failure over the next 10 years. This is an unfortunate truth that never gets mentioned in implant literature… just like root canals always work… according to the endo literature they do anyway
thank you for replying! I will bury the implant next time.
In these cases, do you do the second implant at no charge? I did not charge again for the second bonegraft
You can bury the next fixture if you want to but I always do single units as one stage… just my preference as someone who was trained on tissue level Straumann and have carried the single stage concept with me for 20 years. I never charge for a replacement for up to 5 years post restoration. In my practice I guarantee everything for up to 5 years but in order to do this I use exclusively ZimVie TSVM and Straumann TL because they have weathered the storm since 1998. I am a fee for service practice and I am not in network with any insurance so I am able to get full fee and guarantee results. I understand that this is not practical in every situation but its the only way I can sleep at night… I charge a premium fee for a premium product with a premium guarantee. Expensive but well worth it IMHO
same opinion. Failure is part of implant treatment. don’t beat yourself up. All you can do is keep trying. implant is not 100% successful. i do not charge for repeat placement. your failed implant can be returned to manufacture for warrantee refund/replacement. So it’s reasonable to repeat placement for free.
you can bury implant. but if failed, implant will still be exfoliated. There’s so many factors involved w/ implant placement. any variable can affect osteointegration. So just consider sometimes “shit happens” so don’t feel bad.
FYI I have never grafted the site of a failed implant at the time of removal but rather just lest the site heal naturally. I think “we” in implant dentistry get entirely too graft happy and forget the basic principals of wound healing. The site of a recently failed implant is at the bare minimum a 3-4 walled contained defect and these contained defects/holes in the bone have been spontaneously healing and filling with bone for centuries before we started interfering with osseoinhibitory graft materials. I use bone grafts and membranes daily but after 25 years of practice I am still not convinced that they are necessary for contained defects and likely reduce the amount of vital bone present vs. native un-grafted defects. Clot stability is the key to bone formation and the best clot comes from the native blood cells in the region rather than from a jar of dead mineral. Bone grafting, particularly socket grafting, is probably the most profitable and unnecessary procedure dentistry has seen since the sealant that is usually placed by an unassisted hygienist deep underneath a sea of saliva…
