Dark Area on Mesial of Implant: Cause for Concern?

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See the final film 3 years post implant placement. Note the dark area on the mesial. Is there something going on? The implant is stable, no pain, good soft tissue healing, no bleeding on probing, no swelling. Thoughts?






9 Comments on Dark Area on Mesial of Implant: Cause for Concern?

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Stefan Gollwitzer
4/26/2018
Hi, as you inform us, no clinical symptoms to be reported, so just wait and see, x-rays are sometimes overestimated.... regards Stefan
Neil Bryson
4/26/2018
Thanks for the good progression of X-rays This could be just a less dense portion of bone that never filled in as well as the remaining bone around the implant. I see a very pronounced laminate dura from the first X-ray thru the healing cap phase. There also seems to be less density in the same area as you progress. This could be a bone scar similar to what is noticed around a very large endodontic lesion that does not completely resolve even after great endo. These are asymptomatic and often never resolve even with retreatment. The only thing that worries me is that I also notice some radiolucency developing on the distal in the last X-ray. This could be just the difference in angulation or possibly an area of pathology developing. Your only approach is to monitor, advise patient, and wait for symptoms or more significant radiographic changes. Think positively!
Monika kumar
4/26/2018
These images are 2d. If you are worried, I would recommend CBCT and then go from there. With technology we have, there should not br second guesses.
Steve Darmstadt
4/26/2018
All the radiographs are at slightly different angles, as expected, and therefore appear different. Personally I would not be concerned. The implant/bone interface looks good to me. A cone beam could perhaps corroborate, but even then, a scar in the bone could appear less radiodense. I would watch.
CRS
4/27/2018
What was done at extraction and grafting to treat the localized osteomyelitis? The bacteria may still be there.
rrodds
4/27/2018
My notes state that the granulation tissue was removed, the socket filled with Grafton D mixed with amoxicillin and the socket was covered with an Osteogenics Cytoplast TXT 200 single barrier, which was removed 4 weeks later.
Dr. Gerald Rudick
4/29/2018
In our line of work, we can never be sure that the site we are going to place a dental implant has been completely devoid of previous pathogens and deleterious cells....... we take an educated guess through radiography.... in this case, if it is asympromatic, the best choice would be to monitor the situation with time and see what happens...at worst, the implant will have to be removed, and the area cleansed (?) ; regrafted and a new implant placed.
DR J
5/10/2018
I would not worry. Wait and see.
Harari
5/11/2018
No worry Let it go