Implant Abutment Screw Coming Loose and Bone Loss?
Larry asks:
Hello, I am a 28 year old male. I lost an upper right central tooth (No.11) when I was 14, following from a bike accident. I have had an implant (3.5mm - 15mm) since I was 18 years of age. Unfortunately, I have experienced some problems in the last 4-5 years with the abutment screw coming loose. This subsequently led some bone and soft tissue loss. Although there was a couple of attempts to tighten the screw and re-model the crown, the same problem keeps on occurring, and the gingiva still shows signs of irritation (due to the movements of the abutment). The implant, however, is intact.
The dentists/surgeons that I have seen tend propose to extract the implant, graft bone in the area after the extraction and then re-implant the grafted site (over the span of 1 - 1.5 years). Some other dentist has advised me to leave the implant as it is and try to graft bone in the area to fill in for the lost bone and re-attempt to tighten the screw. Since I have had a bit of misfortune with this implant, I would very much appreciate any suggestions. Many thanks!
Hi Larry,
Trying to nurse this implant along the rest of your life will be frustrating. Grafting bone against an implant that is experiencing bone and tissue loss will be technically very difficult and I find that the success rate of this procedure is unsatisfactorily low.
Therefore, I would recommend implant removal, bone grafting (and possible soft tissue grafting), and retreatment with a new implant and crown. Please discuss this option with your dentist.
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loose implant
Is the methodology in constructing implants so varied that if I go to a dentist who did not install the abutment and
crown (to tighten the screw) that he will not know what to do? The dentist who constructed it is no longer in practice and I was concerned that a new dentist will not know the structure that was used and so won't know how to tighten it!!
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