Multiple implants failing: anyone familiar with this system?
Patient presented to the office with multiple implants, most of which are failing. I do not recognize the brand of fixture. Anyone familiar with these?
(click to enlarge)
![]unidentified fixture](https://osseonews.nyc3.cdn.digitaloceanspaces.com/wp-content/uploads/2013/02/Vane-e1360179422268.jpg)unidentified fixture
14 Comments on Multiple implants failing: anyone familiar with this system?
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Sav
2/6/2013
I may be wrong and this does not answer your Q..but is your Pa over exposed…can you play with the contrast if digital?…may have a bit more crestal bone than is showing.
Sorry if not relevant
Sav
Richard
2/7/2013
There are 4 implants in her mouth that look OK, so I would try to maintain those, There are one or 2 that are questionable so I will explore them surgically and see if they are salvageable and there are several others that will be coming out and the areas grafted.
I am not sure what we will be left with, I am just at the preliminary stages of this case, but even if all fixtures needed to come out I would at least consider holding some for purposes of provisionalization.
The implants were placed in NY several years ago and apparently the clinic vanished with no forwarding address. Perhaps this was not the only case that did not go well.
RICHARD
2/7/2013
The image is a little over sharpened because I wanted to bring out the detail of the reverse flute design. These have a little more bone than shows on the image.
TTT
2/6/2013
No clue, but they look externally hexed which would make the mesial? implant look semi normal for bone loss to the first thread.... the rest of them look bad
CRS
2/6/2013
I have a really dumb question, are you planning to restore these failing implants vs removing them? If you were restoring then you would need to know what type? Are you going to remove? How long have the implants been in and are they mobile?I don't recognize them is there any history from the person who placed the implants? I guess what I 'm asking is what is the treatment plan. Thanks.
Richard Hughes, DDS, FAAI
2/8/2013
These implants with a reverse buttress design, are from a company that was purchased by Biohorizons. The reverse buttress is not the issue. It most likely from occlusal overload or some sort of off axial loading.
Richard
2/8/2013
Thanks for the lead. I am not blaming the implant design or anything else for the problems, The patient was in a domestic violence situation which had her in a bad place for a couple of years, so I am not sure about how they were maintained or the state of the restorative that was on them. She is doing OK now so I am going to do my best to straighten her out.
Sousadds
2/14/2013
I checked with Bio Horizons and they do indeed own the manufacturer of these fixtures. Although they don't make or sell the fixtures anymore they do have all the components. Thanks for the help.
chirurgien
2/12/2013
The image is a little over sharpened because I wanted to bring out the detail of the reverse flute design. These have a little more bone than shows on the image.
Dennis Flanagan DDS, DABG
2/12/2013
Psychological stress has been implicated in this type of bone loss around implants. There is some evidence with respect to teeth, but almost nothing on implant bone loss. If there is abuse here, this is an etiologic consideration. Flanagan D. Stress.....JOI 36(4):325-327. The implant design or material is probably not the isuue.
Jeff Fox, DDS, FAAID, MMD
2/14/2013
almost looks like a nobelactiv to me.
sousadds
2/14/2013
this is very possible, her life seems better, but I am going slowly with this.
ajay singh
3/3/2013
Friend,
forget about the system. remove the abutments using screw driver of any implant system, put the cover screw of any internal connection implant, use the tent screws for space maintenance, do the vertical bone augmentation, release the periosteum, close the flap with watertight closure, reopen after 6-8 months, you will see new bone till the top of your implants.
other way is- remove and replace the abutments with cover screws and let it cover by soft tissues in a week or two and then perform the vertical bone augmentation with the tunneling technique.
if feel difficult to do it, buy the implant book "CLINICAL IMPLANTOLOGY" from Elsevier at www.infibeam.com to go through these and several more amazing techniques in implantology.
Sousadds
3/3/2013
I am considering all options at this point, thanks for your input
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