2 Implants in Lower Anterior Region: Viable?

At the time of implant placement ..I noticed very mild mobility of lower right implant. So give me suggestions with the period of time after 3 months it will become firm & steady or not...??

Always treatment plan the case with the prosthetic goal in mind. If you wanted to utilize the implants to help retain a tissue supported mandibular overdenture, the implants would offer the most benefit if they had been placed more distal, and you have plenty of room distally before you have to worry about the IA nerve and mental foramen. The more distal placement would have also given you the opportunity to place one or two more implants close to the midline for increased stability of the overdenture. As far as the primary stability question, it is a gamble. I have seen implants that rotate at time of placement become integrated after a few months, but it is not what you want to see at time of placement. Good luck!

First the X-ray you posted is non diagnostic. I can't evaluate what was done. A panorex would have been more helpful to see the placement in relationship to the entire mandible. AP spread in support of a tissue borne over denture is an important consideration. One key factor be certain that the denture is relieved in the implant area while the implants are integrating. I would have retaken those films immediately, the artifacts obscure the bone and they can't be oriented. It is a simple and important basic. It is also your record. Placing implants in the mandible is not as simple as it seems, anatomy is challenging, nerves, vascularity and the floor of the mouth are all factors. Plus it is very easy to get disoriented. I always recommend working with an experienced surgeon as a team it is the best case scenario for the patient. If these implants fail then you have a colleague to have your back. Two implants in the lateral incisor position is not ideal for retention too close together. I would place two more distally if I had an X-ray to evaluate the anatomy. That's how you get better.

I agree with CRS's comments.... it would have been easier to give suggestions if the film was a panorex.......but all is not lost!!!! Wait 4 months for these two implants to osseointegrate, and the place ball attachments on them....this way the patient will get some stability for the lower denture, while waiting for additional implants to be placed and give more stability..... or add a few mini transitional implants ( the original Dentatus name for narrow diameter implants) that can be put into function immediately.

Best way to improve placement is to improve diagnosis, investigation including xrays and treament planning. I would wait 5-6 month for the spinner and also ease the interim denture ( if pt has one) in the area of the implant placment. Normally I ease the fitting surface and softline. As for overdenture it would work you have slight angle bw implants so probably locators are the best option. Hope it helps. P.S. CRS beauty of close proximity is atleast more implants can be added ;)

Here is a tip I learned and I am glad to pass it on. For argument's sake, say you are aiming to place an implant at 45 Ncm torque. Do not set your surgical handpiece at 45 Ncm. Set it to perhaps 25 and begin implant placement. If the handpiece stops before it is fully placed, you know you have at least 25 Ncm. Then progress to 35Ncm. And then to 45Ncm. I learned this at a David Gelb course in Chicago...he called it titrating the torque. The point is: if the bone is softer than you anticipated and you started insertion at your goal of 45Ncm, it is too easy to create a "spinner". In the above example, if the implant fully seated when the handpiece was set at 35Ncm, then you know you don't have even 35Ncm of torque. (Otherwise, the handpiece would have stalled and you would need to increase torque up to 45Ncm.)