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[Others] loose implant post 5 wks surgery

50-yr-old healthy man complains of loose implant 5 weeks after implantation.

45, 46, and 47 implants in place on Mar 1 with torque at 35 Ncm at the time of implant insertion.

3 weeks after implantation, complains discomfort to apex of 45 and 44 area. Percusion 44+, 45-. 44 RCT done on the same day.

Went to China the next day of 44 RCT. Complained of loose 45 during week 5. Went to the local dental office and Dx: loose implant 45 with PA.

File 1: 45 CBCT

File 2: Week 2, PA F/U, No S/S

File 3: Week 3, PA with 44 RCT

File 4: Week 5, PA from local dental office in China

Questions:

1) What is the suggested treatment for this case?

2) How to use Doxycycline during the infection site cleaning?

Thank you for the comments!

by Edward Zhang at Wed, Mar 30, 2016 4:02 AM

2265 Views | 3 Replies

Attached Images

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Edward Zhang Replied at Thu, Mar 31, 2016 11:53 AM

Hi Albert, Thank you for your thought out comments and recommended plan of action. I have learned a lot from this case. Based on the patient's requirements, my treatment plan was to place 3 individual implants between 44 and 48. Driven by the surgical stent, I made implant 45 and 46 only a little bit more than 3MM (or 4MM) apart. I overlooked that the actual measurement from distal of 44 to Mesial of 48 on the bone level is much longer than the measurement from occlusal margin of distal 44 to Mesial of 48. Therefore, I adjusted the position and angulation when I placed the last implant, implant 47, accordingly. As you mentioned, I could position the 46 fixture more distally to get a better result

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Edward Zhang Replied at Wed, Mar 30, 2016 4:15 AM

Photo 1": 45 CBCT ***before implantation(exo and bone grafting 3 month after)

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Edward Zhang Replied at Wed, Mar 30, 2016 4:09 AM

Photo 1: 45 CBCT Photo 2: Week 2, PA F/U, No S/S Photo 3: Week 3, PA with 44 RCT Photo 4: Week 4, PA from local dental office in China--Dx: loose implant 45