Flap dehisence: What should be done?

I placed this 5×11.5mm implant in the lower second molar region. Patient is a chronic smoker.  After a week, the patient presented with flap dehiscence. I re-sutured and again the same picture. Next time I completely raised the flap and passively approximated the edges and re-sutured. But the same picture after a week. Now I decided to let it be. Patient was asymptomatic until last time but now he complaints of intermittent pain in the implant site. Also when I raised flap to re-suture I noticed 3-4 exposed threads on buccal side.  I flushed this area out.  Now what should be done? There seems to be no infection. The problem is the exposed cover screw.

2 thoughts on “Flap dehisence: What should be done?

  1. DrT says:

    Put pt on Perigard bid for several weeks. Re-eval in 8-10 weeks and consider secondary procedure, being very careful to release buccal flap as atraumatically as possible to insure primary closure

  2. Gary OMS says:

    Just polish the exposed threads and let it heal secondarily. Delay loading. Patient is also a bruxer, you ought to tell your lab tech how the crown should look like.

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