Hi,
I placed a immediate and used a customized abutment.
Customized abutment loosened at 1 month so I decided to replace with a healing abutment. As soon as I turned it in then the implant spun. I understand the stability graph and perhaps should not have touched it.
I removed some granulation tissue that was buccal of the implant. Flushed. Put in bone and placed a cover screw and submerged.
Am I just delaying the inevitable with this implant?
You can choose to wait for two months and try again but in my opinion it most likely will not integrate and will probably need to removed.
Unfortunately I think you are in fact just delaying the inevitable… The fact that you initially placed a transmuccosal customized abutment tells me that there was likely some fairly good initial stability, at least enough for you to feel comfortable doing one stage. While the stability curve would suggest some loss of initial stability I think spinning at 1 month is a failure. Get it out of there and place a new fixture in about 6-8 weeks using sharp drills and copious irrigation… I am pretty sure that you just wasted a jar of graft dust trying to rescue it but that is the cost of doing business. Good Luck!
I’m afraid that you’ll have to bite the bullet on this one. It’s better to find out now that you have a spinner and toss in the towel and start from scratch rather than have a complete failure in 6 months from now . Degranulate the osteotomy well and irrigate with saline. Collaplug is useful too. It will all turn out well 12 months from now
once there’s granulation tissue touching implant, what means there’s biofilm on the implant.
so no amount of removing the granulation tissue and grafting will have any improvement in integration of bone to implant. just like previous drs indicated. just remove and graft and return after 4-6 months.
did you place bone graft between implant and bone at the initial implant placement? if you placed an immediate implant. im assuming there must be space between the implant and bone?