Female patient, 55, free MH, smoker. Patient received 8 upper implants (immediate implant placement) at the end of June 2020. All of them had been torqued over 35 Ncm. Implants loaded the day after placement. Yesterday, I removed provisional to check the acrylic jig. All implants are ok excluding UL5. Pt mentioned slight tenderness during manipulation. Tried to move the implant, but the implant didn’t seem to acquire mobility. No pocketing around UL5, non BoP. Still, the patient is clear the the implant is tender when trying to move or rotate the implant. Is the implant failing? To load or not? Thank you
Pain on torque is not a good sign. Usually indicative of fibrous union. I can appreciate slight RL around the threads. Most likely the implant will be able to be reversed using your placement tool. Best to remove.
Looks like encapsulated implant, remove ASAP. Happens to all of us, procrastination doesn’t fix it.
Agreed with all previous posters. It is best removed. The decision is on you as to replace it with another one immediately or delayed.
On another note, the name is visible over the patient’s x-ray…
Julie Nederkoorn comments:
Thank you for your replies.
I agree that the implant is encapsulated and has to be removed.
What is very difficult to comprehend is the reason, in order to be better next time.
Faisal Moeen comments:
Remove of-course. No ambiguity here. Would you rather make a new prosthesis and then remove in a few weeks? It’s a gonner and good to know now then later. Don’t let it’s failure bother you even a single bit, having said that, don’t cantilever the next prosthesis. These are small diameters and not too long. Load the hard palate and make a nice good looking removable. Tell the patient that’s what’s best for him/her.
Integration does not look healthy on Xray. Occlusion?
Remove and graft