Bicon Implant Fell Off Upper Lateral: Reasons?

I placed an immediate Bicon 3x8mm implant after extracting the maxillary right lateral incisor (UR2).  The patient developed pain for 2 weeks after and the implant exfoliated at night while the patient was sleeping.  Could the fact that this was a short implant be a contributing factor?  What could be the reason for this?  Has this happened to anybody else?

29 thoughts on: Bicon Implant Fell Off Upper Lateral: Reasons?

    • Ashwath M Gowda. BDS., DDS., FAGD. says:

      “The first mistake is using Bicon.”
      If it happens to be a “mistake” to use Bicon….
      What would be your “explanation” for the BICON implant system being continually successful and still in existence, or even going strong for several decades?
      Could it (such success) be made possible by proper/ly,
      A. Understanding the methods and materials involved, in the first place and
      B. By following, at least, minimally meticulous operative procedures and then
      C. Execution of
      1. The required and “incident specific” procedures being followed and
      2. Finally, making sure, that necessary, appropriate and “clearly made understood” post operative instructions being delivered and religiously followed by the patient/s.
      I am ready to admit, that placing a titanium “wood screw” would be a mistake…
      Just kidding!!!

  1. Devin Savage says:

    You need to give us more information. Implants are very dependent on their environment. In order for use to help you, we need to know more about the environment of the implant and the sequence of events.

  2. Gregori M Kurtzman DDS says:

    In an immediate extraction site key is initial stability or at the least implant to bone contact. a 3x8mm implant in an immediate lateral extraction site I do not think would have much implant to bone contact and was essentially floating in the socket. I have no issues with using a Bicon implant but in an immediate extraction situation I would place an implant that is as wide as the tooth being extracted at the cervical and as long as the root from crest to roots apex.

    • Mark Bourcier says:

      Yes, what Dr. Kurtzman said. You need primary stability and you choose too narrow an implant. Did you graft around it and place a membrane? You need something to hold it still because if it moves it will not form bone around it.

    • Angela Ganjoor says:

      100% agree with Dr. Kurtzman. I have been placing Bicon implants for many years and have not had any issue with it. As he mentioned ,you must engage the bone for stability.

      • Mark Bourcier DMD FAGD says:

        I too have had massive success with Bicon and wholeheartedly endorse them. Some people would say that immediates are a good place for a threaded implant to engage bone at the apical extent of the osteotomy and that is true. However if you choose a Bicon size that is roughly the same as the diameter of the tooth being extracted, or otherwise provide for some bony walls in contact with the implant, a Bicon will integrate. If you take a tiny Bicon and place it into a cavernous extraction site with no graft and it is just rattling around in there, the odds are it can not integrate.

  3. Peter Fairbairn says:

    Not Really , we routinely push Implants into a synthetic graft material with no Primary or bone to implant contact and seem to have a higher Osstell reading at 10 weeks than if placed into host bone with an initial high Primary.
    Have shown video cases …… but it is just a thinking process
    I enjoy how much we do not know and trying to find out why and how .

    • Mark Bourcier DMD FAGD says:

      Can you be more specific? You push an implant into synthetic graft material with no frictional fit of the site whatsoever and they integrate? Why do you do that? What implant and what material? What are the specifics? I am not doubting you but it files in the face of every article written about primary stability and would love to hear if that is false.

      • Peter Fairbairn says:

        Yes agree , and hence only an idea not a protocol but have done over 100 cases with only 1 failure in 3 years .. Will post a video case with 2 year follow up here soon . This is merely for thought I am not saying for anyone to do it .
        But it helps us learn more about host healing and bone regeneration .

        • Nicholas Busuttil Dougall says:

          I can attest to this. I am in the process of restoring an implant inserted in the LR6 region following surgical removal of the 6. A 5.1mm implant was simply pushed in the socket after I had filled it with Ethoss. The only stability obtained by the implant was through the hardening of the calcium sulphate. Closed primarily.
          6 months later I had to remove hard healthy bleeding bone off the top of the implant to access the cover screw. I tried reverse torque of more than 60ncm and it wouldn’t budge. PA rad shows nice homogenous bone all around.
          Given the right conditions the bone will heal well. No movement, no pressures on the site no co morbidities, and allowing enough time for the body to heal will produce amazing results.
          Of course this cannot always be reproduced due to a multitude of factors which are different for each case. However experience and keeping abreast with current research helps us make the right choices.
          Good luck

  4. Peter Hunt says:

    Enduring pain following an implant procedure can be an indication that the implant site was overheated in channel preparation. The pain endures until the overheated bone sequestrates and is lost, often coming out with the implant.

  5. Matthew Watson DMD says:

    Hate to say it but implants fail. They have lots of courses on failing implants. Best thing to do is put your head up and don’t lose sleep. I have lost sleep and put my head down when it’s happened to me and it solved nothing. Graft the site and return in 4 to 6 months a place another. Be sure you have good buccal bone and things will be good. And a cbct to verify width.
    Good luck

  6. Merlin P. Ohmer, DDS, MAGD says:

    Immediate implants are tricky. Many more factors than a healed site. Primary stability is keys. You have to have it. Implant was too short also. Try to grab some good bone in the future.

  7. Dr R Y says:

    Need more information ,like before and after Radiograph, cause of extraction (if any pathological condition before placing an implant must be very good curette ), have a look on adjacent teeth peri apical health as well any systemic disease, rest of the things agreed with doctors need to place little wider implant as an immediate loading

  8. perio-d says:

    As others have said, we’re only guessing without more information. An x-ray and more written description is needed. But a guess anyway: tiny implant in a permanent tooth socket must mean no stability. Was there a temporary pressing onto the implant? This would make a difference. With such a small implant I can’t imagine there would be over- heating of the bone.

  9. implant guy says:

    bicon is a funky implant. Use a tapered implant like Implant Direct, with a long history. Using a straight step drill and a tapered implant to gain initial stability in softer bone, patented by Dr Niznick. Buttress threads, to mini threads, self tapping groove. Blasted surface to the top.

  10. implant guy says:

    bicon is a funky implant. Use a tapered implant like Implant Direct, with a long history. Using a straight step drill and a tapered implant to gain initial stability in softer bone, patented by Dr Niznick. Buttress threads, to mini threads, self tapping groove. Blasted surface to the top.

  11. John Manuel, DDS says:

    Having successfully placed Bicon implants for many years, I’m surprised one would consider immediate loading without some coronal support. They’re designed to fit snugly without much pressure on the bone to avoid the common resorption before healing scenario.

  12. Paul says:

    Of all things established, primary stability is an indisputable fact. In a fresh extraction socket one has to consider the geometry of the space where the implant will be placed. If the implant will be placed exactly into the socket of an anterior maxillary tooth where the geometry is oval, it will be difficult if not impossible to achieve primary stability. Going past the apex or palatal to the axes of the socket will achieve the goal.
    One can test that principle in wood or hard synthetic material. Mechanics is mechanics no matter the medium.

  13. Hasan says:

    Thank you guys … every comment noted and valued !
    Reflecting on the case , I think the main reason for failure in this case was
    Narrow implant in a large osteotomy . Maybe an overheat .
    I didn’t think the pilot drill went through the palatal bone at the time , though I was hoping it did ..
    apparently primary stability is not important in Bicon ??? How accurate is that, ??

    • Mark Bourcier says:

      There is no insertion torque value with Bicon, because it is simply placed in an osteotomy. But it can’t be rattling a round loose. If the socket is filled with blood and grafting material and you get good closure then that can work just fine, but if it is just moving around every time the patient takes a step, it is likely to fail. There should be enough contact with the adjacent walls that the implant is held still, and ideally graft material placed into the gap around it.

      I would encourage you to take all of Bicon’s courses and then do their observation day to ask any questions you still have. Their courses are excellent and relatively affordable.

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