Is it too early to decide on implant failure?

I installed 2 short 6mm implants with 4.8mm diameter. Bone was not good. I achieved primary stability of 40 Ncm. Patient returned at 2-weeks complaining of dull pain. She also had pain on palpation. Are these failed implants or should I wait a few more weeks before I make a decision? How long do you usually wait to make a definitive determination of implant failure?

10 Comments on Is it too early to decide on implant failure?

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Gregori Kurtzman, DDS, MA
12/29/2015
What sites were they placed into and do you have a radiograph to share?
Gregori Kurtzman, DDS, MA
12/29/2015
also was these loaded or left with no temp restoration?
DrT
12/29/2015
Can we see some images
amgdds
12/29/2015
An answer to the question seems "BUILT IN" to the perception of... achieving 40Ncm torque ???????? "I installed 2 short 6mm implants with 4.8mm diameter. Bone was not good. I achieved primary stability of 40 Ncm." where in it seems, achieving 40Ncm torque with A. a 4.8x6mm implant being placed into, B. "Bone was not good." seems clinically unachievable, may not require any other proof for being a failure. Failure, means unfavourable or unanticipated symptoms as being presented here.
hamidreza ziaee
12/30/2015
i think it is better to take cbct and verify arund of the implant and adjacent teeth
KPM
12/30/2015
I have found that persistent pain of really any degree is the tell tale sign of an implant failing. We all know how it can go, too....pain for a few days, maybe not even any pain, followed by either worse or no pain then mobility then removal with fingers at between 10 days and 3 weeks. That being said, once an implant is in place, it'll take absolute mobility or persistent, moderate discomfort for me to take it out. Even though I know in my gut it isn't going to take! Why? Because we've all had those very few cases that exhibited pain for a few days or longer and, low and behold, subsided and the implant was fine. So I don't see any steadfast rule. Like much of what we do, it's a case to case, experience, gut feeling based decision. At least it keeps things interesting!
Dr.Mario
12/31/2015
Well, pain sounds already like a not promising prognosis, but I think there's information we need in order to truly evaluate the situation, how does soft tissue look like? Xray, traces of infection? Pictures, xrays or even better CBCT Scan will help a lot to know about it. Please catch up about so we all can learn. Greetings!
Doc Moose
1/1/2016
If implant wobbles or depresses it's a failure. If it spins only(a little) then maybe ok, maybe!!!
Dr Fernando Campos
1/3/2016
X rays and location of implants would be helpful, also is there any transitional denture causing direct pressure over implants site?. Did you go for one or two stage protocol. The information you gave us is not enough to give you a sound opinion.
CRS
1/10/2016
Here is my simple protocol in the initial two weeks there should only be soft tissue pain from the surgery itself which improves daily and is controlled with meds. Once the patient is past that I check them at 6-8 weeks when the implant is most vulnerable from mechanical stability to osteointegration. I tell the patient that the only way I know if all is well is lack of pain. I also give the caveat that I truly know if the implant is successful is at the final exposure with no mobility. The key for decision making is the six week point, if thing don't look good best time to remove a non integrated implant and start over. Then there are the late failures after restoration which are usually multi factorial. Based on the limited information presented and no film it sounds like to me that these implants need to be removed. Welcome to the unpredictable world of dental implants!

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