Topic

[Surgery]  Implant too close to adjacent root? what do I do?


I just placed both these implants this morning.  I was able to get 35N on#14 thus healing abutment and only 15N on #24 thus placed a healing cap.

Although I know that this is a 2D image, I am wondering about the proximity of the implants to adjacent canines especially #24.  

 

Your thoughts.

 

 

sincerley,

 


by Mark Kwon at Fri, Sep 23, 2011 2:58 AM

2066 Views | 8 Replies

Attached Images


Replies


Likes : 0

Bernard Jin Replied at Fri, Sep 23, 2011 1:14 PM

I agree that a CT scan is in order - especially if you are in doubt. If the patient is complaining of an unrelenting toothache - it may suggest you've impinged upon/thru the lamina dura and into the PDL. Again - confirm it thru cone beam CT. - Bernard



Likes : 0

Mark Kwon Replied at Fri, Sep 23, 2011 3:04 AM

I would recommend another CT scan before making drastic decision.



Likes : 0

Mark Kwon Replied at Fri, Sep 23, 2011 3:03 AM

Hi Mark, This is my patient that I placed implants in #14, 24 last week. As you can see, I'm not happy with the placement of the 214 implant location as being really close to root of the #23. Patient is not having any real discomfort around the #23 but I'm wondering if it would be best to remove the implant and reposition a new one and fill some allograft bone material into the previous site? Or should I send him for another CT scan to be absolutely sure before doing anything?



Likes : 0

Mark Kwon Replied at Fri, Sep 23, 2011 3:02 AM

Pt often complains of TA or sensitivity in such case.



Likes : 0

Mark Kwon Replied at Fri, Sep 23, 2011 3:02 AM

Thanks Mark. What if any symptoms would he feel if the implant has hit the canine? I'm also really upset I couldnt make the CT scan course this passed monday.



Likes : 0

Mark Kwon Replied at Fri, Sep 23, 2011 3:01 AM

Yeah.



Likes : 0

Mark Kwon Replied at Fri, Sep 23, 2011 3:00 AM

Hi Mark, So without taking another ct scan, is there something that I should be watching out for from the patient in regards to any symptoms he may be feeling if implant is causing a problem with the #23 canine? From what you see in the pan, do you think the #23 canine is fine and the implant will be fine?



Likes : 0

Mark Kwon Replied at Fri, Sep 23, 2011 2:59 AM

Often implants at first bicuspid position can look a little distorted. You are right td to judge from 2d imaging. However , one Of the reason for implant appearing alot closer to canine is because canine roots are much more buccally positioned , where as cuspid implants are much palatally positioned, therefore , in 2D imaging, even if the angulation is little off, it results in significant over lap of Images. - mark