Saving failed implant

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Posted on By Ben Lashley In Failures

55 yo female with an implant that had failed. Implant was removed, bone grafting with "sticky bone" and single chain space maintainer produced good width of bone. Pictures included are of second implant placement and subsequent healing. Sorry the photos are not that great but notice recession on distal facial of premolar. attached gingiva could be managed with split thickness at opening but I would like to make sure this is augmented right. How would anyone address the next step? CT graft on premolar first and if so how> combination CT while placing healing abutment? Let me know how I can improve the soft tissue outcomes.

Ben Lashley

soft tissue healed

second implant 3mo healing

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Here are two more photos of the current situation. Note also the small defect directly over the head of the implant. Not concerned terribly but it at least makes me raise an eyebrow. What if I go in and find poor bone, I could graft again and raise the whole thing up some but not sure how to simultaneously address the premolar. Ben


Ben; A combination of uncovering the implant and autologous CTG over implant site and adjacent tooth. This must be secured with sutures to locate and stabilize graft. As an aside, the implant you selected here has a wider diameter at the neck which most often leads to bone resorption at the crest. Notice your radiograph, it appears to have started. We prefer low profile neck macro geometry and platform switch implant concepts to minimize these potential issues. Good luck Dr. Salama


Ben; I am giving a 2 day hands-on Soft Tissue course in April in Washington DC area if you are interested. Here is the registration link if you are interested.


Ok, I have registered and will see you in April. I will bring my questions about this case and stall treatment until after then. Thank you for your input!