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Medical Forum / General / Dentistry / February 2007

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Implant post did not set

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Bob - 15 Feb 2007 19:21 GMT
I had a single tooth extraction, upper in front of molars, and dentist
put in post for implant. After several months when fitting the tooth,
it was apparent that the post was loose. So he wants to put in some
different post. I question the success of trying another procedure and
having the same problem of the bone not being sufficient to hold the
post.

Now I have a manhole cover on this post.

My questions are can I call it quits now and just leave the post in.
This is not a tooth that I would miss all that much.

Also, to leave it would have have to put some other cover on the post
as food gets under this manhole cover.
Mark & Steven Bornfeld - 15 Feb 2007 20:30 GMT
> I had a single tooth extraction, upper in front of molars, and dentist
> put in post for implant. After several months when fitting the tooth,
[quoted text clipped - 10 lines]
> Also, to leave it would have have to put some other cover on the post
> as food gets under this manhole cover.

    If the implant is infected, it should be removed.  Whether you have it
replaced or not is another story.  I've recently restored an implant on
a patient who had it placed at least 3 and possibly 4 times.  I'm not
saying you should be that persistant (personally, I wouldn't have been,
but I wasn't in on the decision-making process), but chances of success
and how much you'll miss the tooth are of course important factors in
your decision.  But don't leave an infected implant in.

Steve

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Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001

JimSocal - 15 Feb 2007 21:01 GMT
>> I had a single tooth extraction, upper in front of molars, and dentist
>> put in post for implant. After several months when fitting the tooth,
[quoted text clipped - 20 lines]
>
>Steve
Just curious: If it's NOT infected, couldn't it just be covered by the
gum and sewn up, as mine were while waiting for the implants to
integrate with the bone?
Mark & Steven Bornfeld - 15 Feb 2007 21:34 GMT
> Just curious: If it's NOT infected, couldn't it just be covered by the
> gum and sewn up, as mine were while waiting for the implants to
> integrate with the bone?

    Ordinarily this is what happens; the fixture is placed, the gum is
sutured over.  Sometimes the head of the implant fixture becomes
exposed; I've seen this happen, and while it isn't considered ideal I've
seen these cases work out just fine.
    The OP states that his implant is covered by a "manhole cover" which I
take to mean a healing cap.  This is done after second stage surgery.
After a few weeks the implant is ready to be restored.  But I wouldn't
attempt to cover an infected implant, and after all the implant is there
to use.  The rationale behind suturing over the fixture after placement
is that it gets to heal (osseointegrate) in a sterile environment, not
exposed to saliva.
    When implants fail to integrate, it is often not possible to tell why.
 One patient of mine had several implants fail; they were placed before
the risks of bisphosphonate use with regard to bone healing in the mouth
were well-known.  She did NOT suffer osteonecrosis; OTOH, the implants
failed, and the surgeons are considering the possibility that her
medications were related to the failure.  No way to know though, and
subsequent implants worked out fine.

Steve

Signature

Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001

Bob - 16 Feb 2007 00:13 GMT
No, it is not infected at all. The Dr. wants remove this metal implant
and  install a different type of implant. I am exploring just calling
it quits as I don't have confidence in a second one working and why go
through all this if the tooth is not that important. I had two other
implants on the other side and they are great. I am on old guy and
have enough teeth to last me.

So if I quit you say it needs to be covered to prevent infection and I
understand that. I take it the metal can remain inside OK.

Thanks.

On Feb 15, 1:34 pm, Mark & Steven Bornfeld
<bornfeldm...@dentaltwins.com> wrote:

> > Just curious: If it's NOT infected, couldn't it just be covered by the
> > gum and sewn up, as mine were while waiting for the implants to
[quoted text clipped - 25 lines]
> Brooklyn, NY
> 718-258-5001
Newbie - 16 Feb 2007 20:01 GMT
>No, it is not infected at all. The Dr. wants remove this metal implant
>and  install a different type of implant. I am exploring just calling
[quoted text clipped - 7 lines]
>
>Thanks.

I don't get why the doc would want to remove a properly
integrated implant.

IIRC you said the implant was loose, if this is the case
it is almost certain that the bone is infected even though
it may not hurt.

If the implant is loose, get it removed and be done with it.

If properly integrated, a healing cap will at least protect
the attachment portion of the implant, you can always
have a crown attached later if you wish.
 
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