Implant unscrewed during healing collar removal: indication of future failure?

Was this an immediately placed implant and at what position? If so, what influenced your decision? Biologically, 2 weeks is not long enough for osseointegration/ secondary stability, couple this with the poor primary stability you mention at placement (which is still all you are relying on 2 weeks later) and movement on testing the implant fixture at this point will occur. However, it is too early to deem the implant an 'early failure' at this stage. In this instance I would consider at least delayed or ideally late loading up to six months and I would have buried the fixture then uncovered at a second stage surgery before prosthetic restoration. Hope this helps and good luck.

This is as you know the low point of the Implants integration .... sadly these are the basics of implantology .....Why ? Peter

It wasn't osteointrgrated Bubba. It's not like a wood screw it takes 12-16weeks for the bone to grow into the implant. Was the transmucosal abutment or the implant " installed" two weeks prior, your statement is unclear. But regardless an osteo integrated implant does not move, there is soft tissue in there, I would advise taking it out and starting over.

Why were you removing the healing abutment at 2 weeks? you can currette the site and if dimensions of the bone allow place a wider longer fixture but let it heal for at least 3 months

Implant is at its weakest phase at two weeks. Why were u removing the cover screw at two weeks? Unfortunately this implant is unlikely to integrate. Remove and if the bone volume allows modify the osteotomy and place a larger implant. Otherwise graft the site and re enter after 4-6 months. Good luck

Well duh, CRS, nothing is integrated at two weeks. Don't be condescending. In fact, as pointed out earlier, it is the weakest time in implant integration and the implant should not be manipulated. The questioner did not specify if the movement was strictly rotary, or was there a side to side component to the movement? If it was strictly rotary then re screwing the implant back into the site and leaving it alone for 3+months may allow the implant to integrate. I have had the old machined branemark implants rotate in the osteotomy site after 3-4 months of "integration" but since the movement was strictly rotary, allowing further integration time allowed these implants to be successful. with the newer surface treatments/roughened surfaces integration is much more predictable even when initial stability is less than optimal so allowing this implant to integrate without manipulation may allow it to be successful. If there was side to side movement then I agree that this implant is more at risk and should be removed.

I usually bristle at the snide remarks that are sometimes posted. Then I read... "I was removing the transmucosal healing abutment from an implant fixture installed 2 weeks prior when the implant began to spin in the osteotomy site. Primary stability acheived at the time of implant installation was less than optimal." Hmmmm....why would you be removing the healing cap at this time? Histologically there are a whole bunch of things going on that even this lowly prosthodontist knows at two weeks from which to stay away. That is implant dentistry 101. And you knew there was poor initial stability? I will be the first to admit that since 1982 I have made my share of mistakes in implant dentistry. During that time I have experienced three implant learning curves: 1. prosthodontics, 2. surgery and now 3. Rescue. All I can say is "Come on in...The water is warm!" I truly wish you and your patient good luck. There is a good chance if you just re-torqued it without removing it will integrate. Fingers crossed for you.

I have the same question as some of the others. Why would you remove the cover screw at two weeks? The bone is dying back at the two to three wk point. Tighten down the implant and replace the cover screw. Give Mother Nature a chance. Are you using one of the tantalum implants? Who makes up this stuff?

But what was installed 2 weeks prior, implant or healing abutment?

Hello If you won't get the enough torque while screwing in the implant, you should always cover it with a cover screw and bury it. Wait for at least 3-6 months depending on the type of bone and then uncover and do the remaining procedure. Now also you can screw in the implant respecting the anatomical landmarks as you haven't mentioned the site, bury it under gingiva covered with a cover screw and leave it for 6 months or you can remove the implant, wait for 3 months and redo the implant. Final decision is yours. Best of luck dear.

Prognosis is grim. It sounds as if you didn't take the implant out, but there is connective tissue between the implant and bone. Why are you uncovering fhe implant at 2 weeks ? B Vinci

I think you shouldnt have removed the covering screw until atleast 3 months of loading now what i think is it will be better to keep the implant covered atleast for a period of 3 months and the try removing the screw regards