Exposed Threads on Nobel Groovy Implant: Bone Grafting Techniques to Perserve Implant?

Dr. A, asks:

I have a patient with a Nobel Biocare tapered groovy implant where 4 threads of the implant are above the bone level. The patient also has about 1mm of bone loss circumferentially around the implant. The bone level on the teeth adjacent to the implant is normal. I would like to preserve this implant. Are there any kinds of bone grafting procedures and techniques that I could do to accomplish this?

6 Comments on Exposed Threads on Nobel Groovy Implant: Bone Grafting Techniques to Perserve Implant?

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SG
9/6/2011
Some x-rays would be helpful, along with some kind of history, including when the implant was placed. Thanks
Dr. Omar Olalde
9/6/2011
Dear Dr. A, I agree with "SG", it would be useful if you present an X ray and give more information. So the procedure may change depending on the next: -How long ago the implant was placed? -Did you graft the site? -What about the inclination to the labial wall? -Can you diagnose a periimplantitis or the gingival tissue is healthy? -How deep the implant was placed? Good luck.
Baker vinci
9/6/2011
I have had some fair success with removing the crown( having the restorative guy actually remove it) and placing the cover screw back on. After tx the implant with the concoction de jour , I graft the area with prp and autogenous bone and a resorbable membrane, again with passive closure . I have done this twenty times, max. With what appears to be about a 85 percent success rate. The general consensus on this website, seems to be you can't grow bone to an implant. I tend to disagree and feel like if the patient is compliant , the benefit outweighs the risk. I have had more than half of these cases grow so much bone over the screw that it had to be removed upon uncovering. Bv
Aslan Gokbuget
9/7/2011
Dear Dr A.. First of all we need to think about why did it happen?Because if it's because of the position of implant it is sometimes impossible to augment it.I mean if implant is too buccal position for instance..if not the other issue is decontaminatin of implant threads..you should do it before grafting..I use Nd-Yag and Er-Yag conbination for this purpose..ıt really works..Good Luck
Carlos Boudet, DDS
9/8/2011
Dr.A: If the bone level of the adjacent teeth is normal, and the implant has 4 threads above the bone, then either the implant was not placed at crestal bone level, or the patient has to have more than one millimeter of circumferential bone loss around it. You need to post a radiograph and I am sure you would get very useful answers once you provide enough information. You also did not mention the length of the implant and how much of it is still in the bone. In answer to your question, yes, there are procedures to decontaminate and graft around implants. If access to the contaminated surface is feasible, in my office I use the Waterlase laser to clean the surface and soft tissues before grafting.
Baker vinci
9/8/2011
After re-reading your question,I believe I understand that you are inquiring about growing vertical bone around an implant. While it is one of the most challenging aspects of reconstruction,to grow bone vertically,I have had some success with using the implant as a tenting mechanism. As most of us understand, the most critical factor in volume grafting is maintaing the space in which you are trying to grow bone. This can be done with tenting screws as well.some of the best work on this issue is published by one of my "boys" Alan Herford ,from loma Linda . I taught him everything he knows!!!!!! Haha. Search some of his stuff,albeit it is most applicable for bigger cases, it absolutely caries with it ,principles that you might find very useful . Bvinci

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