Loose implant: how to treat this case?

I would remove the implant and curettage the area completely. Place bone grafting material in the socket and allow to heal for six months. Then start the process over. After the crown is placed on the second implant make sure the occlusion is very very light with no lateral interferences. Good luck!

First step vitality test anterior tooth

Verify the implant is mobile, if ambiguous, remove the crown then verify. If the implant is mobile, remove it (generally they pull out easily with your fingers) and plan for new.

I think you've got external root resorption on the canine, I think its been impacted by the #14 implant. Thats a tall abutment on the #14 plus (might be wrong). I think the canine is probably history. Why did the patient not go back should be looked at really carefully. Did they get the implants and then just not see a dentist for 2 years? If they have a "fit and forget" attitude then you may run into a similar problem, I'd be careful with this one

Hi. Would be nice to see DPT to assess full mouth/perio/occl load etc. Looseness is most poss from prosthesis & not fixture. Both crowns are too large & ill-fitting. *Current placement of #14 (1st premolar) is too close to canine with possible perforation? Have u carried out a vit test on the canine? *#13 possible rct? * #14 is not salvageable, needs removal, grafting (GBR or block), & replace after 6/12 to be on safe side. * #15 could last a while longer with GBR & absence of inflammation/infection but as the pt will undergo removal of #14, same modality would be best for #15, as it will fail eventually. *Check perio & occlusal load before staring any t.t. and consent the pt well that re-entry and GBR or graft may have lower success rate; if you place new implants & they fail, you ma end up picking up the pieces for both failures Despite all, this is a nice case if you lie a challenge Godo luck

I´d remove the implant, place a bone graft after curettage the area and check the canine for vitality. Probably you will not be able to save the canine. It´l need a root canal, at least. After six months, I´d place another implant and start all the process over.

Just remove it, then good curretge and bone augmentation ; after 4 month start by new implant.

1.be concern about bone foundation before implantation 2.the technique of implantation ex the torque for first stability.The implant angulation. Temperature heat drill.3size and length of implant.in this case sure to remove and bone graft 4-6 months.can you improve bone foundation.

Hi UR4 implant has perforate to periodontal ligament in UR3 case root resoption , damage in this size may not help with RCT , consult with Endodontist . you need remove both UR3 UR4 implant , also m/ part of crown on UR5 implant need conical shape . good luck

Looks like both implants are failing and both crowns improperly contoured. I would remove both, bone graft, treat the canine endodontically if indicated. Implants should be replaced with longer and smaller diameter implants at proper angulation. Also, without removing both, replacing the anterior implant to the proper position would not be possible.

Remove the 1st bicuspid implant. Also remove the crown on the 2nd bicuspid implant. Both crowns have very poor emergence profiles. Graft the 1st bicuspid implant site and renter later. This failure could be for many reasons.

If you just focus in the implants etc and remove them, curettage, graft and re-do and adopt a "wait and see" attitude for the canine then you will have major problems. The PA does like like an impaction with changes to the outer contour of the canine. A simple endo may work but long term prognosis is poor. The crown on the molar looks over-contoured mesially, the long axis of the #14 implant cannot be altered much without increasing the abutment angulation and worsening the over-contour effect. Unless you bodily move the #15 implant closer to the molar (and make a better crown on the molar) you will not improve the situation- and again after all that what about the canine?

I wouldn't bet the farm based on this one X-ray that the canine is affected, could be a supra imposition of the perimplantitis of the first premolar implant. I would remove the implant graft let it heal then replace. The second implant crown is probably a food trap hence the crestal bone loss. If there are no clinical signs or symptoms on the canine it doesn't hurt to pulp test or get a CBCT. The hard part is that the previous history of why the teeth were lost and how the implants were placed is not known. The good part is that you are starting over and can receive appropriate compensation for helping this patient and correcting the problem.

fair point CRS but if the patient did not go back to see the dentist who placed the implants and its been 2 years since placed then is the dentist responsible? He could say that the patient failed to attend the follow up and review appts and if the #14 is away from the root of the canine (granted the crown emergence profiles are not ideal) then he could refuse to remunerate. The crown contours may have been what the patient requested (close contacts with no black triangles) My concern is the patient history in relation to seeking dental care plus I would try to contact the dentist who did the work to find out what went on, just in case what the patient is saying is not the full story - I still think they've hit the canine but another PA at an altered angle would be good

The implant is toast with the other implant not far behind--lucency clearly evident. The canine is in trouble as well. Remove 5, inspect 4, and if necessary, remove it as well. Give the canine the benefit of doubt for the moment, but external resorption is a possibility.

need CBCT first of all for the chance that the periapical defect is the couse of the mobility...its the only chance to save the implant with root canal treatment of 13 and GBR araoyn the apical zone of the implant after apiectomy of 13! in all other possibilyties i agree that the impant removal and after GBR and new implant placement after 4 months is the solution!

This is a situation for better clinical imaging. Would benefit from CBCT imaging and evaluating the HU's around the cuspid tooth. Like CRS stated, can't diagnosis what is going on with tooth #6, based on a single p.a. .