Is this presentation indicative of a developing pathosis around the implant?

These case photos are a continuation to the case posted: Radiolucent Halo Around Implant Post-Op: Is this Normal. I would like to add the latest periapical xray which is at the 5th week. I am concerned about the way they look. In the immediate post-operative period, is it normal to have a faint radiolucent lesion around the implant? Â Is there inflammation associated with the process of initial healing and osseointegration that would manifest as this faint halo? Â Or should normal healing be accompanied by no radiolucent areas Â — just implant and bone. Â Is this presentation indicative of a developing pathosis that I should be concerned about? Â Should I prescribe antibiotics or anti-inflammatory drugs? Â What do you recommend?

![]Periapical radiograph](https://osseonews.nyc3.cdn.digitaloceanspaces.com/wp-content/uploads/2012/08/R7.jpg)

![]Periapical radiograph](https://osseonews.nyc3.cdn.digitaloceanspaces.com/wp-content/uploads/2012/08/R6.jpg)

10 Comments on Is this presentation indicative of a developing pathosis around the implant?

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John Kong, DDS

8/31/2012

Do you have a pre-op radiograph?

irononfire@gmail.com

8/31/2012

The preoperative radiograph and immediately after placement radiographs are in a previous case post titled â€˜ Radiolucent Halo Around Implant Post-Op: Is this Normalâ€™ which can be accessed from the link in this case description.

John Kong, DDS

8/31/2012

Just saw the pre-op. I think your implant is fine. You placed the implant in an exo socket that's still in process of maturing. I bet there was a tooth there within the past year or so. Take a deep breath and forget about this for 3 months and then uncover. I think you'll be pleasantly surprised.

Itawil

8/31/2012

Looks like you are getting bone loss to the macro thread. Is this MIS seven? Was this immediate extraction case? Halo is of no concern typical of digital xrays around implants.

irononfire@gmail.com

8/31/2012

Yes these are MIS Seven Implants, and was not an immediate extraction case. The preoperative radiograph and immediately after placement radiographs are in a previous case post titled ' Radiolucent Halo Around Implant Post-Op: Is this Normal' which can be accessed from the link in this case description.

Itawil

8/31/2012

I followed link and are aware of previous comments. Loss of crestal bone to the macro thread is commen with this implant. It especially shows up when there isn't enough width for implant placement. Do you have at least 2mm of bone on buccal and palatal side of the implant? Any case photos? I find it imperative to take photos not just for lecturing but to evaluate technique. It's better than a chart.

uli.friess@web.de

8/31/2012

You might have used longer implants in both cases. If they don`t intergrate,then antibiotics are useless. I think ,it`s just like a pregnantcy:it`s yes or no. You won`t find out before you support them.This will be quite thrilling.The design of MIS is similar to ADIN,and with ADIN I had very good success. Good luck,but wait at least another 2-3 month before you continue.

Carlo santos

9/4/2012

Hi I suggest using gel40 or putty from osteobiol, well 1st and foremost assuming that there was no osteointegration whatsoever, indicates a stimuli or irritant, may it be pathological, mechanical or physiologic (RANKL, opg, etc) like flipping a coin it's either you deal with osteoblasts or osteoclasts, whichever cells be the active one, gel40 and putty from osteobiol is a osteoconductive/inductive bone matrix that can be squeezed in like a flowable composite material, let's not forget its an allogenic bone material,

CRS

9/4/2012

Is there anything resting on top of the implants? A partial? You are losing bone height. Any clinical symptoms, exposure? Micromovement will cause the implants to fail to integrate.

Baker k. Vinci

9/4/2012

It doesn't much matter. Are you going to remove the fixture early, if one of us suggest it looks as if it's not integrating. Let the process run its course. If it is not integrated upon second stage, cross the "bridge" then. Bvinci