What Happens If An Implant Doesn’t Fuse To The Bone?
Good morning and welcome to the Shatkin F.I.R.S.T.® Monday Morning Minute.
Good morning and welcome to this Monday Morning Minute. I’m Dr. Todd Shatkin and I’m here to talk to you today about a question that comes up quite a bit. What happens if an implant doesn’t fuse to the bone? In other words, you put some mini implants in you put eight or ten or four and everything seems okay, but a week or two later you feel some movement on that implant. What do you do?
Well, let’s talk about a denture stabilization situation first. Let’s just keep it simple. Four mini implants on the lower jaw. You put four in a week, two weeks, three weeks, four weeks later one of the implants is moving. It’s a little tender. What do you do?
Well, what you do is you just simply remove that implant with a finger driver, take it right out. Normally you don’t even have to give anesthetic for it. But if you’re going to go ahead and place another one the same day of course you’re going to numb it up a little bit. You’re going to remove that implant.
My recommendation is just go ahead and get a new implant same size in most cases and move a couple millimeters left or right, depending on the situation and make a new pilot hole in fresh bone and place another mini implant in that fresh bone site. Obviously, you’ll have to modify the denture, take the housing out, pick up a new housing in the denture, snap it in and the same protocol again.
Have them wear it for 24 to 48 hours before they take it out and come see you after a couple of days. That’s a simple fix for a denture stabilization problem. Same thing in the upper jaw. If you lose one, move it over a couple of millimeters, place a new one. Don’t use the same implant because it’s obviously got bacteria on it and Whatnot.
And put a new implant in and pick up a housing and give that a try. Now, the more difficult situation is if you put a mini implant for a crown and a couple of weeks, three weeks, four weeks later the implant is loose, the crown is loose. If you’ve already cemented the crown, what do you do then? So what I do normally, if it’s got a crown on it I’ll use a crown tapper. I’ll tap the crown off with the implant. Obviously you’re going to numb them up, pull the implant out with the crown. Most times I’ll go to a larger diameter mini.
So if it’s an O-ball mini with a crown on it I’ll go up to a Milo 3.0 or 3.75 and go right in the same socket, screw it in the bone and take the crown off of the implant that failed. I’ll flip it over, cut a little trough around the implant to loosen it, take the crown out, clean out the cement and usually you can cement the crown right back on if you position the implant properly. Okay, so that’s another simple fix for a single tooth. Now, if it’s a multiple tooth situation where you’ve got a bridge or a temporary bridge, I really, really like our new mono implants.
If you have a failed mini, you can go right in with a larger mono, a three, three, seven, or four two mono, and go right in that bone and really engage solid bone. And that works usually very well. But the important thing is to re-drill the hole, clean out any granulation tissue, drill the hole with a little larger drill, and then go in with that mono and engage the larger bone.
The dense bone, with that mono implant that’s got very heavy, dense threads. So those are the ways I solve problems with failing implants. If you want to, you can just take the implant out and wait a while. That’s perfectly fine. You don’t have to go back in the same day, take it out, clean it out, let it heal. If you want to pack some bone in there, you can do that. Pack some osteogenin and just let it heal for four, six, eight weeks and then go back and try again.
So those are all solutions to mini implants that may not integrate or may fail after time if they don’t work. Listen, we’re going to have failures. We have about 93, 94% overall success, which means five, six, 7% of the implants we place are going to loosen up or fail. And these are the solutions on what to do if that happens.
So I hope that’s been helpful to you. And as always, you can email us, text us, call us anytime you want if you have any questions or problems. I’ll talk to you next time on the Monday Morning minute. Thanks for being here.