Exposure of threads after bone graft?

I like to use EthOss as a graft material [beta-tricalcium phosphate and calcium sulfate].  It works well and is easy to use. I recently uncovered an implant after about 3 months. About 1-2mm of the buccal threads were exposed. But the implant was solid and the biotype thick. So I placed a healing cap and will restore. My question is: if after grafting you have more threads exposed, e.g. 4-5mm, would you graft the threads again and close and wait another few months? Or would you remove the implant and start again? What is your experience and what do you advise?

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4 thoughts on “Exposure of threads after bone graft?

  1. Hi , have done a fair few grafts with it and yes did the correct thing here as with functional modelling and the nature of the material you will get further bone growth over the next few months ……This situation could have been a number of reasons , from size of implant , too buccally placed to the muscle pull on the soft tissue or other host factors ….

    But the main issue is if it was more again too many factors that vary but it has happened once or twice and I clean , prophy jet the Implant surface graft and load which has worked very well . So yes re-graft unless the placement position is deemed to be non-ideal
    ~Due to the up-regulatory effect of the material on regeneration the load and exposure times are shorter than other materials and protocols so in some cases poor host physiology may also come into play .
    Regards
    Peter

  2. It depends first on the position of the implant. If the positioning of the implant is beyond the alveolar housing, bone grafting does not work predictably. Therefore I would first assess the position of the implant. If the implant is in a good position, then, I would consider cleaning the implant (Peter Fairbairn explained it well), and graft.

  3. I would suggest clean and regraft. If that fails I would suggest removing the exposed threads…this may be your first option if regrafting doesn’t seem favorable.

  4. If you are talking about 4 or 5 mm height of threads exposure, I would suggest rather remove the implant, probably you can just place another one, without new bonegraft, that will save you time, and overall less stress for your patient.
    Good Luck!

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