Leaving implants covered for too long: any issues?

Good question, I have had implants buried over two years with bone growing over the cover screw which needed to be removed a good problem to have I told the patient. If the mucosa is healthy and the implant is not exposed to the oral flora I would think it would be okay, I think one gets into trouble with an unloaded exposed implant. I do like to plan for total cost and sequencing at implant placement before placing the implant but life happens. I think one year turn around is a good rule of thumb to get the patient to commit to then it is out of your hands if the patient doesn't Follow thru. I'm sure other posters will have other opinions just my experience here.

Although I've never encountered it myself, I've heard colleagues talk about bone atrophy?

If I knew a patient wasn't able to return for a substantial length of time to restore, I would feel more comfortable if the implant was buried rather than left exposed.

Its not the implant that I would worry about especially if it is buried. I would worry about the adjacent teeth possibly drifting/ tilting into the edentulous space where the implant crown is supposed to go. Further more , one cannot discount the possible supra-eruption of the opposing tooth if the whole reason for this implant was merely to provide stability to the arch and occlusion. A buried implant can stay buried indefinitely as long as it is buried in the sterile environment..... however having said that these buried implants can spontaneously surface if they were placed supra-crestally .

Provided that your implant stays covered with no comunication with the oral cavity there should be no problem. If there is any opening so that oral fluids can cone in contact with the implant there will be a problem. If the tissue covering this implant is thin and it erodes leaving the implant even only a little exposed there will be bone loss and potential for an infection arround this implant. If the tissues are thin it would be best to do second stage surgery and place a healing abutment that will allow for healthy tissue to be maintained. If your implant is in the aesthetic zone and a long term healing abutment is not something that the patient will accept a temporary abutment and crown could be placed. I suggest that a charge be made for this procedure but as it is a part of fabricating a final restoration , and the keep the patient happy, a credit could be applied to the final restoration if it is completed within a reasonable period of time.

I have two patients with a total of 8(?) implants, that have been buried for 19 plus years. I scanned one of them when I got my scanner and even under a full lower they are completely surrounded by bone. This is why our forefathers intentionally left roots.... Bv