Implant failing in extremely dense bone: prospects to replace?

Last Updated March 22, 2018

3 months ago I placed implants in a 50-year old Asian man in good physical health in the 19, 20, and 21 areas. On the pre-op CBCT, the Mn bone in the 20 and 21 areas has the appearance of cortical bone through the width of the Mn down to about 10 mm. Almost an imperceptible difference in appearance from the cortical plate to midwidth of the Mn. I had originally planned to do a 10 mm implant, but after a period of time gave up went with a 6 mm implant. Due to the density of the bone used heavy irrigation, and bur set had only been used twice. PA taken at time of impression for the prosthetics showed a failing #19 with 3 mm bone loss and #20 having lost 3 mm on the distal, but M was perfect. #19 will need to be backed out. When preparing the osteotomy for 19 there was basically no bleeding. Looked like osteotomy was in chalk. What are my prospects for retreatment in this area? I am somewhat doubtful that #2 round bur perforations within the osteotomy will be of any assistance. Thank you


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