No Primary Stability with Nobel Replace?
Last Updated: Jul 28, 2017
Yesterday I had a patient with failed second molar of right mandible that was extracted one year before.We decided to place a Nobel Replace tapered groovy 4.3 — 10 mm.
First I used the pilot drill 2mm and when I reached the final drill for 4.3 (yellow) I started to insert the implant with the motor at 25 ncm. I had checked the walls of the implant bed and the bottom with a depth indicator and xray. Also I had distance from mandibular canal 2 mm.
However, when I reached at the 2/3 of the height of the implant I felt the implant screwing-falling to the bottom of the bed…like falling when you are in a lift..!
No primary stability!! It was a very big surprise for me since I have experience in oral implantology. But it was my first time using the Nobel System. Usually I use Xive, 3i Biomet and MIS.
I decided not remove the implant and I tried to screw the cover screw and it was screwed with the implant (like the whole system implant-screw was spinning…)
I placed sutures and I pray now for a secondary stability while osseointegration process.
What is your opinion? Did you have any similar cases with the Nobel system?
By the way, I was thinking that the soft bone was the cause, and I had to stop drilling with the 3.5 drill, but the protocol says that the final drill had to be the yellow for a 4.3mm diameter implant in any case of bone, and in case of dense bone to use further tapping drills. Thoughts?
27 Comments on No Primary Stability with Nobel Replace?
DRF
07/28/2017
Apostolos
07/28/2017
Anand Patel
07/29/2017
Anand Patel
07/29/2017
D. Yamamoto, ARRT
07/29/2017
Coconuts
07/28/2017
Dr. Fotis Roilos, MSc
07/28/2017
Jeff
07/28/2017
implant guy
07/28/2017
Dok
07/28/2017
Gregori Kurtzman, DDS, MA
07/28/2017
Dok
07/28/2017
Dr H
07/28/2017
Merlin Ohmer
07/28/2017
Dr. Gerald Rudick
07/28/2017
Barrow Marks
07/28/2017
Coconuts
07/29/2017
An
07/28/2017
PAUL BETTS
07/29/2017
Dr. Elijah Arrington III
07/29/2017
hgolnaza
08/02/2017
Merlin Ohmer, DDS, MAGD
08/02/2017
Dr. Mario
11/02/2017
implant guy
11/02/2017
Dr. Mario
11/03/2017
implant guy
11/03/2017
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