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!