Early implant exposure: suggestions?

Last Updated: Jul 24, 2015

I had placed this Straumann bone level implant and on day of placement there was 1 mm exposure of the implant on the distofacial line angle. I had placed a bone graft and PRF membrane and buried the implant. At the one week post-op the cover screw was exposed so I replaced it with a healing abutment. Now the tissues have healed in however on the distal I can see the implant platform since the tissue thickness if only 1-2 mm. Should I attempt to regraft the bone or do a CTG [connective tissue graft] or take out the implant and start over? Any suggestions would be appreciated. I have attached the day of placement radiograph.

![]Day of Placement](https://osseonews.nyc3.cdn.digitaloceanspaces.com/wp-content/uploads/2015/07/X131NC_4.jpg)Day of placement

3 Comments on Early implant exposure: suggestions?

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CRS

07/24/2015

Here is what I would do replace the flat cover screw and give the tissue a chance to heal over, 6-8 weeks. If there is still thin tissue then place a connective tissue graft if needed over the healing screw under a partial thickness flap. The purpose of the graft is for long term stability of the gingival tissues not esthetics. I would not remove the implant it is fine. The healing cap just pushes the tissue away and thins it out. The patient can lightly dab the area with peridex tid for hygiene once the tissue settles down. A clinical photo would be helpful.

Rut

07/28/2015

I would not remove it look fine to me

Hank D. Michael, DMD

07/29/2015

I agree with thicker tissue for long-term stability. Good suggestion to replace cover screw and let tissue heal over. 2nd stage tissue graft. It would be beneficial if you could achieve primary closure after cover screw placement.

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