Screws from block graft can be seen thru tissue: how long should they be in place?

I am working up a case on a patient that would like 2 implants placed #7,8 region [maxillary right lateral and central incisors; 12,11]. I normally fabricate a surgical guide and send to the oral surgeon. This patient had a block graft done over 18 months ago. The heads of the screws can be seen thru the thin tissue on the facial. There are 3 screws and they extend from the buccal plate almost to the palatal. What is the length of time they should have been in place? The patient did not return to the oral surgeon that placed them and I will encourage them to return or refer to another oral surgeon.

6 Comments on Screws from block graft can be seen thru tissue: how long should they be in place?

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CRS
1/4/2013
Once the block is integrated the screws can be removed. They may be loose and moving causing irritation .
Frank Avason
1/8/2013
Hopefully your patients graft hasn't resorbed being 18months since this procedure was completed. Encourage them to get to an implant surgeon soon. Get a CBCT and evaluate B/L width for fixture placement and plan the case before they lose the reason why they needed osseous grafting. Concerning the screws, they can become sore to the patient due to thin tissue and will be removed when fixtures are placed.
VR
1/8/2013
From what I understand after speaking with Oral Surgeons and researching and talking with sales reps, 6 months is sufficient for healing with screws in place. Too long and the screws can osseointegrate and too short and the bone graft will come out with the screws!
Diorgenes Machado
1/8/2013
You can easily remove the screws flapless by a very small incision over its head if it´s causing any irritation.
walid BH
1/9/2013
you should place your implant after 4 to 6 months since graft placement to stimulate osteogenesis of the graft and minimise its resorption . 18 months is too long . Don t wait, start with the case . .
raymond d kimsey
1/9/2013
Note to VP- Please don't depend on sales reps for surgical advice.

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