Normal Pattern of Bone Loss

I get situations like this referred to me quite often where the referring dentist diagnosis “Bone Loss around Implant”. I will let each person reach their own conclusion but I would consider this normal for the type/design of implant that was used… I did not place this fixture but it appears to be a Bio Horizon (terrible product in my opinion) with a traditional flat top internal hex connection. Prior to platform switching/medialized abutments/conical connections it was considered normal to see bone loss down to the first thread. While we could criticize the placement and or diameter of this fixture I do not believe it has pathological bone loss but rather a normal pattern for the device that was used…

I guess one of hint that this is Normal, physiological bone loss, or as some others might contend, “formation of biological width around an implant.”, is the fact that the bone loss should be monitored overtime after loading for 1+ year, to see if bone loss is actually increasing before deeming it “Bone Loss”. Cortical bone is evident around the implant from that PA.
Also, I have had some resolution of bone loss or actual “growth” (Dare I say that word) by just adjusting patient’s occlusion at times, so need to diagnose the issue before sending the patient to you.

My $0.02

Several obvious problems: first there was enough bone loss that the implant was placed too far apical to the adjacent teeth/attachment. Second if a wider implant was used that would eliminate most of this problem. It’s a pretty small diameter implant for a molar. I prefer 6mm implants in that site and my GP’s love it. I agree that it is “normal” bone loss for the situation…I question if that bone loss will continue due to excess stress on a small diameter implant > microleakage and the patients challenge to clean an implant that is that deep. My .02 cents!!


All great observations but the original post clearly stated that the implant is not ideal in placement or diameter so I am not sure what you are trying to portray with your comment. I assume that you agree with the notion that this is a normal pattern for the situation and the other factors are irrelevant.

I got those key observations in your post. As I follow this thread and the AO version, I note that when multiple practioners think alike, it helps me have a new or unconsidered idea “sink in”.

Yes. This is a normal result for a mishandled case. I’m guessing you’d observe it and if bone loss continues, remove it and correct the problems.

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