I had placed an Osstem 4x11mm implant in 36 region 3 years ago. I used a rigid abutment. It is a non-hexed screwable type one piece abutment for cement retained crowns. It is meant to cold weld to the implant fixture once placed under required torque. For some reason screw loosening happened 2 times and I placed the same abutment back again. Eventually the screw broke. I retrieved it. The implant also shows a crack line on the labial surface and around 3 mm of bone loss labially. The patient is asymptomatic. Can I place a hexed 2 piece abutment, which would not put an expansion pressure on the implant and aggravate the crack line, and use it in a bridge with another implant? Or should I not take this risk and try and remove the implant? What would be the prognosis if I were to load this implant with a technically more sound hexed abutment? The patient had gotten other fixed prosthesis work done with another dentist when she was away. I will be working on the current occlusion she has.
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