Dr. Gonzalez from New York asks:
I am wondering about others experiences regarding dental implants that spin in the osteotomy but that are not loose and clinically seem to have no gap space from bone to fixture.
Would you recommend to wait a longer time for osseointegration to occur?
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My experience is that the implant will become firm [integrate] with more time. I believe the literature verifies this concept, but I cannot quote a source.
There are experiences that show that if an implant rotates and you cover it and protect it from load and leave it it would integrate if there is no clear radiographic gap.
Re-integration success of Osseotite implants after intentional countertorque liberation in the edentulous mandible
Volume 15, Number 1, July/August 2006
Lucente J., Galante J., Trisi P., Kenealy J.; Implant Dentistry; Vol. 15 No.2 pp 178-185; June/2006
check that.
good luck
Yes, I can speak from personal experience. At least an additional 3 months and you should be fine.
I prefer to remove the implant and install a slightly wider one to achieve «terminal» screwing and good stability, then go on with planned treatment.
In “the old early days” of machined Branemark fixtures, when you followed the drilling protocol using all the drills and taps, you could easily end up with a spinner in soft bone in the maxilla where you could rotate the fixture as you inserted the cover screw by hand–and the “bail out” size for the 3.75mm fixture was 4.0mm-not very much difference for fixation in a stripped osteotomy. In my experience, as long as the fixtures were not loaded and the osteotomy was round, not oblong with space between the bone and fixture, you were fine if you waited an extra two months before uncovering. Now, if a fixture spins in a precisely drilled round osetotomy, I might consider going up a size in diameter if possible, but I would not be concerned if a fixture could be rotated in the osteotomy because of the present day surface treatments. An extra two months should take care of it.
Don’t we have it already well established, widely published and universally accepted as a fact that preventing “MICRO-MOVEMENT” of the implant is “THE CRITICAL REQUIREMENT” (among many others) for successful integration of implants?
Agree get it out and replace with a bigger size stability is vital.The rotation is probably due to micro downgrowth or ingrowth of soft tissue , problems ahead
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The implant system I am currently using advocates the use of an osteotomy drill with the same diameter and size of the implant I am placing. The result on occasion is a “spinner.” I have still found that these implants have integrated after 3 to 4 months (submerged). I am planning on switching to a system that utilizes a drill that is narrower than the implant you are placing. The advantages? An implant that can be indexed for insertion of a temporary crown at stage two surgery, or under favourable circumstances can support a temporary crown (out of occlusion) at the stage one appointment, two things that cannot be done with “spinners.”
I have complete overdentures both upper and lower. One of the implant screws will not stay in. I recently moved so I am not able to go back to my Dentist that did the work. The dentist i went to see does some work with implants but cannot get the screw to stay in and is telling me I need a whole new implant inserted. The implant is 1 year old. He did try one of my other screws in and this would not stay either. Can any of you please tell me if there is anything else to do. He also charged me for the torque tool and for another tool that went down into the implant shaft, which did screw in down lower. Any advice is greatly appreciated!
Maureen