Unrestored Xive implant fixture: thoughts?
This is a patient from overseas who has had an implant (Xive – 5.5mm diameter) in #14 site [maxillary left first molar; 26] 2 years ago. This is the radiograph provided by the patient, and she wants the prosthetic replacement to be done as she has been transferred to another dentist whom she is not very comfortable going to. So I have inherited this case. I am not sure on the restorability of the implant. How do you think I should proceed?
IOPA the patient sent me
4 Comments on Unrestored Xive implant fixture: thoughts?
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ttmillerjr
10/9/2014
I'll assume everything is fine with the implant and we are going to restore it. Generally with cases like this you'll make the crown fit to the more mesial tooth. It looks like if you put a crown on the molar behind it and make the implant crown the size of a molar you'll close the diastema. Sometimes in cases where the posterior tooth is too angled and there is too much room to fill with an implant crown you'll have to consider leaving a diastema or extracting the tipped posterior tooth and add another implant.
CRS
10/11/2014
I'm guessing that this was placed to avoid the sinus and there is nothing wrong with a cleansable diastema. I would just be cautious and have the patient sign a detailed consent. Three yellow flags, overseas patient, second dentist, and less than ideal placement. Clinical appearance vs periapical can be deciding factor! Good Luck!
rsdds
10/15/2014
nice case for summers technique i know that some dentist like short implants and they've been proven to work but I wouldnt feel comfortable doing a case like this. what is the radiopacity in the sinus??
Gregori Kurtzman, DDS, MA
10/21/2014
appears two teeth are missing and the implant is poorly placed with possibly some thread exposure due to bone loss. I would take a new radiograph to properly eval it as you dont know when the pt sent one was taken.
I am inclined to remove this implant and place two 4.0 wide fixtures with a summers type approach
