Implant placement next to existing implant with severe bone loss?
This patient had an implant installed in #14 site [maxillary left first molar; 26] 8 years ago by another dentist. I extracted #13 [maxillary left second premolar; 25] due to extreme mobility. Extraction occurred 3 weeks ago. The patient has now requested that I replace #13 with an implant. Any recommendations?
![]image1](https://osseonews.nyc3.cdn.digitaloceanspaces.com/wp-content/uploads/2015/06/image1-e1434643269210.jpg)
6 Comments on Implant placement next to existing implant with severe bone loss?
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CRS
6/19/2015
Is the implant mobile? Do you have a pre extraction film?
Francis
6/23/2015
The picture does not look right. Existing implant is off plane of forces by extreme tilt, cantilevered crown, periimplant bone recession, vertical bone loss at the socket and compromised interimplant bony crest if you plan to place an implant. I believe removal of the implant and proper CT diagnostic , and bone augmentation prior to implant placement. Implant supported bridge can be an option.
Regards
Laz S
6/23/2015
I would agree with Francis. The threads on the medial of the #14 implant are not in bone - by consensus this will fail sooner or later. Resist the temptation to place #3 until #14 is taken care of as well.
sirus
6/24/2015
Hi
Test if implant has mobility then remove it and put two implant in UL4 and UL6 with bridge, if implant is stable then remove crown and stoning of implant to crest bone and seal with amalgam then two implant br as above .
Hope it helps
drt
6/30/2015
"Any recommendations?"
Tell the patient he is not a good candidate for an implant at this time.
Just because a patient wants an implant, doesn't me he gets an implant. Does he understand why he lost the natural tooth? Are you trying to educate him in any way? If the real teeth are mobile, that means the bone is not supporting them. How is it supposed to support an implant?
If the existing implant is mobile, remove it and recommend an RPD. If the patient refuses, send him out. You will be liable for the implant failure, which will happen, trust me. He won't remember you doing him a favor by placing the implant. He'll sue and ruin your reputation.
Look at the big picture. How healthy is the rest of his mouth? Can you post a panoramic or FMX? Or photos?
PeterFairbairn
7/2/2015
Agree , this is not an ideal placement for many different reasons but it has been there a while and will probably be there for another 20 years .
THe loss of the bone distally was more due to the mobile 13 ( 25 ) that was removed and on its loss the modelling of the bone would further this loss .
Placing an implant in the area with grafting could well restore this bone loss even on the adjacent Implant .
In the UK we advise the options to the patient and they make the choice ...
Peter
