Circumferential bone loss around implant: should I worry?

One month after placement of splinted crowns over implants in #31, 30 sites [mandibular right second molar and first molar; 47, 46] the panoramic radiograph shows a gap between implants and bone all around the implants even though on the same day of cementation, a periapical radiograph was taken and that space was not present. Unfortunately I was not able to see the patient clinically. I only got his panoramic radiograph sent to me. Could it simply be an artifact? Or should I worry ?


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10 Comments on Circumferential bone loss around implant: should I worry?

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peter Fairbairn
9/5/2014
If Implants stable , sure they are , then an artefact ... Peter
Amir
9/6/2014
Thank you for your input. As soon as I see the patient clinically I will inform you
Alex Zavyalov
9/5/2014
It seems to me a fibrous tissue surrounds the implants instead of osseointegration.
Richard Hughes, DDS, FAAI
9/6/2014
If not on the PA, then it's an artifact.
CRS
9/7/2014
Very good question, too early for that much bone loss compare with post op periapical. I agree with artifact. Is patient having any symptoms? Who took the film? Did they call you to confer?
Amir
9/7/2014
Ok, just saw the patient clinically took a PA and no bone loss shows, the implants are well osteointegrated and the patient has no complains. So thank you all for your feedback and I hope this radio graphic experience will be beneficial for all of us. Thanx a lot
Gregori Kurtzman, DDS, MA
9/9/2014
Could be an artifact and not uncommon on PAN's take a new PA and verify that is or isnt there.
AAslamOMS
9/10/2014
This used to puzzle us a few times; then realized that on panoramic films; especially either digital or manual digitized, the contrast enhancement leads to a uniform radiolucent (thick PDL like) band around all radiopaque structures. Best is to identify the same rim around the metal in crowns and even enamel, which is quite reassuring.
alex kiri DDS,MD,PHD,,FAC
9/16/2014
LOOKS OK
Konstantinos Kordatzis
11/10/2014
Believe it or not I see it quite often around my Ankylos implants and not on any of the other brands I have used. It always looks worse on the PAN than in the PA and is NEVER associated with bone loss or pocketing and instability. It is not a matter of how a particular PAN X-ray was taken because it shows repeatability to the same particular implants and is there even after several years. Therefore, I cannot consider it an X-ray artifact but I am quite confident that is not an evidence of some form of pathology . However , I would also like a convincing explanation on the matter.

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