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Submit Tissue Around Failed Implant for Biopsy?

posted in Dental Implant Complications, Surgical Placement of Dental Implants, en

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Dr. F. asks:
I am a general dentist and I place most of my dental implants. I do not do sinus lifts or distraction osteogenesis or anything too complex. The problem is that I recently had one implant fail. What I have done is to remove the implant, curette the area and place bone graft. I have prescribed 2 weeks of antibiotics. Most of my cases go well. I am careful about case selection. My thought here is that maybe I should have submitted the tissue around the failed implant for biopsy. Is this the correct protocol? Any recommendations in case this happens again?

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7 Responses to “ Submit Tissue Around Failed Implant for Biopsy? ”

• Alejandro Berg January 13th, 2009

  
  

  That doesnt happen to me often either but there is no real reason to get the tissue biopsy… actually what can you get from the result? INFLAMATORY infiltrate in soft tissue or something similar.
  best of luck

• mateit January 13th, 2009

  
  

  To be concise: No, I don’t think you should have done it.
  To comment a bit on the subject : Taking a biopsy in your case (strictly for scientific studies, I can’t think of any other reason) would have involved the bone tissue as well as the gingival tissue. So it would not have been a practical/sane intervention.
  From what I understand you have done everything well and corectly (from a medical pov) for your patient so you don’t have to worry. I presume this is your 1st failure - as long as you have resolved the case and communicate to your patient (almost) everything involved, the only thing left to do is to come up with a new treatment plan for this case.

• DrAslanian January 13th, 2009

  
  

  The patient history would dictate the indication to biopsy. Any history of cancer would be a definite one. Metastatic cancer can and has manifested as granuloma looking tissue in the mouth after surgery. I had a patient who developed a soft tissue mass in an extraction socket which was not healing and resembled an infection. It was actually renal cell carcinoma. In the ABSENCE OF SUCH A HISTORY, there is little indication for, and no information gained by doing a biopsy.

• Dr John A Murray January 15th, 2009

  
  

  Some implants fail; drop it in the desert and move on!

• R. Hughes January 16th, 2009

  
  

  Sometimes the patients biology is poor ie. you may be replacing a tooth with a failed amalgam apico. In my experience these areas are poor choices for implant tx. Also some patients do not follow post op instructions. These two are very much understated in the literature. You also fave to consider the tension placed on the bone at the time of placement, fixation, heat etc. These things happen, if you go into the kitchen-sometimes you get burned. Don’t worry about it.

• Dr David Harpaz February 2nd, 2009

  
  

  The reason for the failure is unknown. The lack of osseointegration in the site is probably not due to diseased soft tissue and therefore there is no reason for biopsy. If there was any visual abnormality at the gingival tissue prior to the dental implant surgery, a biopsy should have been done before the surgery regardless. You did the right thing to bone graft the area and with complete curettage of the ossteotomy and a membrane, you are going to be able to place a new implant within six month assuming patient is in good general health.

  Good luck.

• Faina March 15th, 2009

  
  

  I had an implant done just three month ago. This week the doctor put a crown. Now I have a pain, this is a tooth number 4. The pain goes from the bone to my head. What is the cause of this problem. Should I continue to have implants done or not?

  Thank you

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