I placed this implant about 10 years ago. It was at a different office. About 2 years ago the patient started coming to my practice for followup. #18 implant had severe bone loss but is still osseointegrated. The gingiva is firm and appears healthy without bleeding or purulence. The patient is asymptomatic. I believe the bone loss was from a TMJ appliance that was overloading the implant. Initially I adjusted the occlusion in 12/2018. I then found out in 8/2019 that she has been wearing a TMJ appliance that was putting pressure on the implant crown. Is it acceptable to observe or be proactive? Any advice would be appreciated.
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