Radio-opacity interference with implant success?

I have a middle aged female patient who wants to replace missing #13, 14 with implants.  My treatment plan is for 1 implant in the the first molar site with a cantilevered second premolar.  There is not enough space mesiodistally for 2 implants.  There is a radiopaque lesion in the site that a radiologist has diagnosed either as an enostosis or a retained root.  Will this radiopaque lesion be a problem for the implants?  Your thoughts on this case??

16 thoughts on “Radio-opacity interference with implant success?

  1. Benjamin Selden says:

    The lesion looks suspiciously like a root tip. You can almost visualize the canal space and even possible resorption around it’s apex. If the extracted tooth was ankylosed that would be a likely result.
    If it is to interfere with implant placement, it’ll need to be removed, and grafted appropriately.

  2. Denture Guy says:

    Looks like a root tip to me and it should be removed. If not sure and it is a root tip you run several risks . One of them is the PDL soft tissue creating a softissue encapsulation of your implant
    I’m not sure a cantilevered pontic off an implant in the functional zone is a good idea You would be better placing 2 undersized implants and connecting them. You can create space with C&B, ortho, enameloplasty

    • Craig Wright says:

      I agree-Biomechanically, mesial cantilever would be unpredictable. Better two smaller implants splinted. Remove rt and graft.

  3. Eric says:

    These are obviously impacted bilateral canines. Remove them (no biopsy needed) put a bone graft in sites. implants in 3 months.

  4. Doc Lock says:

    Sure looks like a pair of palatally impacted cuspids. Remove and graft for most predictable results. Consider ortho consult to see if they could be brought into place?

  5. John Burch says:

    This is my take. If the cuspids have not caused trouble in 30+ years, leave them alone. As for the radio opacity, you can probably leave it also. Place two narrow implants, not one. Then make sure you have a comprehensive treatment plan, to manage, financially and biomechanically, the failing alloys on the lower left, possible failing C and B on the lower right, future endo on 18 and 19, and missing teeth on the upper right. Also, you had better get on top of this lady’s hygiene or the implants will fail and you will have to do them over at your expense.

  6. Ben Selden says:

    I encourage those diagnosing the “ canine impactions” to enlarge the radiograph and note the red arrow demarcating the lesion in question. The canines are clear enough, and could be an issue, but not the one the original poster is questioning.

  7. Andy K says:

    Don’t wake up sleeping lion. If the root tip is not bothering patient, leave it alone. Plenty room for 2 implants ( # 13 & 14) without touching the root tip.

  8. Dr R Y says:

    Impacted canines can be seen clearly, if patient have no issue leave it or refer to orthodontist advise,2 small implants are pretty good option with cantilever

  9. ROBERT T CADALSO says:

    The radio opaque area is distal to the canine obviously an area of sclerotic bone (perhaps condensing osteitis) had a similar case biopsied it and took FOREVER to heal these areas tend to not be well vascularized my opinion avoid implant into area go mesial or distal to it

Leave a Comment:

Comment Guidelines: Be Yourself. Be Respectful. Add Value. For more details, read our comment guidelines. Though we require an email to comment, we will NEVER publish your email.
Required fields are marked *

Posted in Clinical Cases, Surgical.
Bookmark Radio-opacity interference with implant success?

Videos to Watch:

Dental Implant for Lower Right Second Molar

This video shows implant placement on the lower right second molar.[...]

Watch Now!
Saving a Bridge with Periodontal Therapy

This video shows a case involving a 48-year-old male who was referred for periodontal treatment[...]

Watch Now!
Immediate Loading Full Arch

This video shows a case of Immediate loading of a full arch with simultaneous guided[...]

Watch Now!
Apically Repositioned Flap Technique Around Implants

The apically positioned flap is a commonly used surgical approach, that may help the long[...]

Watch Now!
Digitally Planned Bone Augmentation and Immediate Implantation

This video shows a case using the Ring technique to provide bone augmentation along with[...]

Watch Now!
AnyRidge Implants: Replacement of Upper Left Molars

This video shows the replacement of maxillary upper left molars with Megagen AnyRidge Implants.[...]

1 Comment

Watch Now!
Guided Implant Surgery & Immediate Temporisation

This video demonstrates the placement of a missing pre-molar using computer-guided surgery and immediate temporization.[...]

1 Comment

Watch Now!
Implantoplasty to Treat Peri-implantitis

This video shows the use of the Implantoplasty technique to treat peri-implantits. Granulation tissue and[...]

9 Comments

Watch Now!
Placement of Implant Using EZ Devices

This video demonstrates the placement of a dental implant in the upper jaw using the[...]

Watch Now!
BonePen: Improve Positioning of Implants

A short video demonstrating close up the use of the BonePen Kit, a set of[...]

Watch Now!
Vertical and Horizontal Bone Augmentation with Khoury Bone Plates

This video shows a way to utilize thin autogenous bone plates to create stunning bone.[...]

4 Comments

Watch Now!
Maxgraft bonering: immediate implant placement

This video shows a live surgery using the maxgraft bonering, which is a pre-fabricated[...]

1 Comment

Watch Now!