Dr. SC asks:
I placed a Keystone 5.5 x 8mm implant in #19 site [mandibular left first molar; 36] 2 weeks. Upon completion of the installation, I discovered a dehiscence on the lingual side of the implant with one thread exposed. The reason for using short implant was to avoid the inferior alveolar nerve which was located about 10mm from the alveolar crest according to her CBVT scan. There is adequate primary stability.
However, I am worried about the epithelial downgrowth from the lingual side which I am concerned may interfere with the apposition of bone and compromise the osseointegration.
Should I remove the implant right away, bone graft, and delayed another implant placement before any integration occurs, or should I leave it and prep the margin gingivally 3 months from now if it integrates?