Short Dental Implants Case: Any Comments on this Approach?

If it is not broken, don't fix it. Keep an eye on it, maintain it. If something starts to happen and it is failing, not the end of the world. It's a short implant and therefore, not a big deal to have it removed and start all over again. But for now, just let it be.

this implant was malpositioned palatally creating a buccal cantiver and potential hygiene challenge. short implants work well but off axis loading in heavy occlusive sites will prabably fail in componentry .

Interesting approach. I would have questioned the angle if not for the obvious clinical success. I would certainly not consider it in a bruxer. My short implant reference is "Short Implants: Reality and Predictability" at IneedCE.com (it is free to read).

Dr D, just a correction to your comment, the implant was not angulated to avoid a sinus lift. It looks a sinus lift was performed, however the implant was angled to avoid the septum which would have been in the way. I have had a similar situation where I had to angle the implant to avoid the septum, but it wasn't this extreme. In any case, as suggested, just leave it alone and monitor. Thanks for sharing.

Can you supply the length and diameter of the short implant here? Also, the brand/manufacturer of the implant is hard to discern from the X-ray here -- would you divulge it, please? (Also the material...pure Ti I assume?) I would like to do a mechanical analysis of the case, which appears to be successful even though (as others have suggested) it might have been questioned to start with.

Cool. It kind of reminds me of other dentistry that violates accepted priciples but still "work". Things like 6 pontic fixed bridges, short posts etc. I see these things as more luck than predictable dentistry yet we are all greatful, for the patient's sake, that they are working. I am not a big fan of compromising implant design and/or surgical principles to avoid "necessary" surgical procedures. My guess is if we were to follow a larger sampling of these cases over a longer time frame we might gain a realistic perspective on their "success"

I have been using short Endopore implants for about 17 years with excellent success (but also with the odd failure). The old rules of crown to root ratios don't apply with implants, particularly if the components are made from Titanium alloy. Pure Titanium components are considerably weaker than the alloy ones (alloy up to 9 times the strength of CP Titanium) and need much more attention to the forces placed upon them than do those made from Titanium alloy. The surface area of the implant placed is also important, as is the implant to bone interface. So it's not the length but the surface area, boney interface and material strength which are more important in implant placement and loading than implant length and crown to root ratios.

You did an excellent job doctor. Due to the diameter and incredibly accurate placement this will work. Patient is instructed to moderate eating habits for 6 months and practice excellent hygiene. Furthermore implantologist is obligated to be extremely careful with & to eliminate all lateral interferences. What a great innovative service you have provided for this patient.

Look at the bone height. It looks good,in fact,better than a lot of more conventional implants. Leave it alone As stated "if it ain`t broken,don`t fix it"

3.5 years after placement. If there's no bone loss after 1 year of use, there shouldn't be any issues. Going back and asking whether if using/placing implant like that is a good idea is unwarranted and pointless. The answer is right in front of you isn't it??? Look at the dang thing. Think a little for yourself. Just because it differs from what you were taught doesn't mean it's more right/wrong. It's working no????

Good, less than ideal but working palatally placed but: more buccal woudl require more attached tissue longer implant wou;ld require a sinus lift; ONLY PROBLEM HEREIS DISTAL CEMENT SPILL!!

Nice case and let me tell you that there are some yellow lights: Several teeth with signs of bad hygiene. Is the patient a smoker? if so, he has to know the risks about that habit could make in the future life of implant. In the oral photograph, the distal papilla shows periodontic disease even more in the distal palatine angle and is confirmed by Rx image; the distal crest is damaged and risking to lose bone more and more through time. In my opinion the ethiological factor is shown in the distal area of abutment conection, could be a step or space between implant connection and the porcelain abutment crown. Rx is a bidimensional image and doesn't show the entire contour, I think the problem could be caused by defficient porcelain cervical contour or a cement spill, as Dr. TOBooth said. Regards to all, good luck!

Nice to see such a angulated placement of implant. this will be working fine if its a morse taper attachment. A screw retained abutment will be a disaster in such situations.

This patient seems to exhibit a lack of canine guidance (blunted canine and flattened posterior cusps) leaving them subject to group function. It may help to bond the tips of the canines and relieve the posterior group function and related occlusal stress just to safeguard against implant crown or component failure...