I have a new patient who had implants installed in #21, 20 sites [mandibular left first and second premolars; 34, 35] by another dentist. He also extracted #22 [mandibular left canine; 33]. The patient presented to me about 2 months post extraction with the radiolucency which has not changed in 10 months. She is asymptomatic, there is minimal pocket dept and the implants are not mobile. She states that she had a pinpoint parulus which resolved very quickly. I have not witnessed this. She has been on courses of antibiotics. Would you go in, debride the area and graft to improve the angulation of the crestal bone, risking further damage to compromised implant? Or would you recommend removal of the implant on #21 which was not done too long ago? Would anyone throw caution to the wind and just place an implant here in #22 site?
(click images to enlarge)
6 month post extraction
10 months post-extraction
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