Evaluation of implant placed in the area of # 13?

Hello Doctor, From the visible radiograph, it seems that # 13 to be too close to # 14 mesial root. Though the angulation seems straight, you'll require an angulated abutment, and the eccentric implant will lead to a mesial cantilever of the crown, which will result to increase in the stress factor.

As you have placed it you should best be able to supply those answers .... bit close to the molar but should be fine to restore . Good luck Peter

Agree with previous posts however this radiograph is inadequate to diagnose off of without seeing the whole implant and adjacent tooth. Is the molar planned for extraction or a new crown? Sometimes we work so hard to fit an implant in when the existing restorations may also require revision. Good luck!

Is the angle of the beam an issue. Regardless, it can still be restored.

Parameters of the X ray had been wrongly chosen and such quality of information should 't have been posted for discussion.

I would like to ask the poster one question: "Would you accept this implant in YOUR mouth??"

The PA only tells about the mesiodistal angulation and no information can be inferred from buccopalatal angulation. If it's not drastically buccally angled it should be restorable. Angulation does not affect the osseointegration. According to recent studies by Tarnow group, a bone-level platform-switched implant can safely be placed at 1mm distance from a tooth. Although creating a cleansable embrasure might be challenging.

Angulation and depth cannot be evaluated by this radiograph as we cannot see the height of the implant in relation to the sinus or its full angulation in reference to the adjacent teeth. From this radiograph, we can evaluate the mesial-distal spatial orientation. I agree it is closer than ideal to tooth #14. Implants placed less than 1.5mm to an adjacent tooth can be at higher risk for sequella such as early crestal bone loss, as well as being a bear to restore.

Very poor x ray for this forum. If you placed it as per protocol with sufficient bone width then there is no reason that it will not integrate. You will also be able to restore it...kind of ...... However the contact point will be very large and flat the crown will have no emergence profile.It will be a very difficult hygiene issue...bone will be lost around tooth and implant. In short the result will be less than adequate. If its not too late remove it ..leave for 6-8 months and place the implant correctly.

I'm curious about the biological width between implant and the adjacent tooth. And what size is this implant?

I agree with all that's been said. There may be some additional room for correction if material can be removed from the mesial of the adjacent molar crown (or a new crown made) to gain some space and this may allow cleaning access to be improved. Something like a metal finish to maximise the correction. Looks like the surface on the other side of the space may require adjustment to improve path of insertion/contact anyway. There's no-one who doesn't make mistakes. It accelerates the learning process

The implant appears close to the tooth root, but this may be due to the angle of the x-ray. If the space between the implant and tooth is as close as it seems in the x-ray image then platform switching and remake of the molar crown along with slight modification of the mesial root of the molar, if needed, (should be no problem with a root canal tooth) can easily fix the problem.

From this angle of the X-ray, it appears too close to the molar, but I think it can still be restored, but may have a broad distal contact. The implant looks like a MIS SEVEN 4.2 diameter at bone level, which is adequate for this area, but need to centre it a bit more. Also, please post better quality X-rays for better replies.

Assuming that the image was taken with the beam perpendicular to the sensor/ film, then we may have trouble in the long term. The inter proximal bone distal to the implant is compromised (<1.5mm) and it will resorb. If not too late, best is take it out, plug the osteotomy with bone substitute, or collagen, wait 4-6 months, and put in a smaller implant, while respecting biology

I feel implant 25 very close to tooth 26, which affect esthetic no convexity at contact may lead to bone resorption solution: use plateform switich abutment, re-make crown 26 to improve contour and contact

Do not use collegen at or very near a site you want to implant. I have been disappointed with the results from collagen, when used for grafting. The bone produced is of a much less quality. I suggest a resorbable particulate such as OsteoGen.