I performed this surgery in the beginning of October 2017. The patient is a heavy smoker. I placed a Straumann BLT SLActive 3.3 x 12mm in the first right bicuspid area. The surgery was uneventful with good primary stability and I put on a healing cap. The patient healed well. I took an immediate post-op x-ray. 21 days later I took another X-ray and it began to show some radiolucency on the crestal area. At 45 days I installed a temporary crown. The implant was osseointegrated with the classic osseointegrated dull percussion sound with no pain. The last x-ray is from today, almost 3 months after implant placement. Do you think the implant is failing? What would you do? Wait to see if it will progress?