Is this implant failing?

This patient had the implant placed one year ago.  Healing abutment was placed six months prior, but the implant has minimal mobility and pain on moving.  Is this implant failing?  What are your recommendations?

8 thoughts on: Is this implant failing?

  1. tony says:

    If an implant has movement and pain on that movement then its not failing, it has already failed.
    Montanas advice is spot on – the longer you leave it the more bone loss will occur.

  2. Ajay Kashi, DDS, PhD says:

    If it is moving and there is pain I would consider this a failed or a failing implant and would remove it ASAP.

  3. Wesley Haddix says:

    An unfortunate outcome: a seemingly well placed implant failing. It happens to all of us; how the failure is managed is the true measure of a surgeon.

    The most likely scenario has already been stated by previous responses: pain on challenge is nearly alelways a sign of failure. Same for observable mobility. For whatever reason, this implant has healed with a fibrous tissue interface. Removal is warranted as soon as feasible. Degranulate the osteotomy thoroughly (there will likely be a ring of connective tissue, and regraft for a later replacement, or place the next larger diameter implant: the bone will be spongy and should accept a larger implant without having to use a larger drill. Final torque should not exceed 35-40 n-cm; higher values can lead to pressure necrosis.

    Evaluate your technique in an attempt to determine if this was a procedural failure or a statistical failure. The proximity of the sinus is an interesting feature, but not knowing how it was managed makes it just that: an interesting feature. IMHO, I personally prefer lateral approaches over crestal approaches for sinus augmentation – that’s just me. Always incorporate antibiotics (metronidazole) into your graft material. Prayers and best of outcomes to you and your patient.

  4. Bülent Zeytinoğlu says:

    Clinical symptoms and x ray shows failing implant which has to be explanted under AB cocerage but the upper border of the x ray is missing.Ä°s the radiolucency an infected bone or is it a lobe of infected sinus.The lesion also shows honey comb pattern so please send the curettage material to a pathologist .if sinus perforation occurs I am sure you will do the necessary manipulation. Good Luck

  5. Julian O'Brien says:

    A loose healing abutment can mimic a failing implant. Remove the healing abutment and evaluate the stability of the implant by placing the insert mount into the implant body. A wider implant could be placed immediately upon the removal of the loose implant albeit with a higher risk of failure …….or not.

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