-
Jedediah posted an update
If this happened to you during surgery, what would you do? Please put your comment below.👇👇👇
Ivan, Cayleen and Erick14 Comments-
Attempt to graft the fenestration and hope for the best. Also make sure to warn the patient of possible future complications.
3-
You can, but with this much of the implant sticking out of the bone, and they’re not being a very prominent undercut, you would be much better at this point to remove and fix the situation, rather than keep a poorly placed implant there at this point, and graft over it. The likelihood of success will not be great in this particular case.
-
-
Once I get a few more comments, I’ll update this post with an x-ray and later explain what we did
-
abort mission, graft, come back in 4-5 months.
1-
That would definitely be the most predictable way to handle that. If I were to do something like that, I would most likely wait six months so I would have more mature, predictable bone healing seeing that I will be going in the second time I want to ensure that everything heals well.
-
-
If you graft does it integrate with the implant? I’ve heard it does not, but why?
1-
It depends on the case. In this particular case, because the implant is protruding so far outside the normal bone biology, it is unlikely that it would be successful. However, if you were to place an implant with lots of bone and biology all around it, except at the very Apex where there was a large undercut, and the implant only took out a millimeter or so in some of those cases, if you were to access that area placed bone graph your own membrane it may heal fairly predictively
-
-
Ok docs, I’ll respond to all of your comments soon but I wanted to update this post with another CBCT cross-section of this case and see if this changes anything for you on what you would do. Please let me know and leave a comment👇👇👇. Once I get a few Responses I’ll answer your comments and let you know what was done and show you a few more pictures and final CBCT on what was done…
-
-
I would remove the implant graft the area and wait. The BIC is no bueno.
1-
That would definitely be the most predictable way to handle this case. However, luckily this patient had fairly wide bone, so you may be surprised on what we were able to do to fix it. I’ll post the rest of the photos this week.
-
-
-
The trick is to catch it. I think we sometimes have wishful thinking and don’t pull back the flap to see whats under the hood :/
1-
Agreed, too much wishful thinking. Much more predictable to just popped the hood and see what’s going on during surgery to verify.
-
-
Ok guys and gals here’s the update on this case and how we handled it at one of our live surgical courses…
Luckily, because the bone was so wide with this particular patient, we are able to treat it kind of like an immediate socket. We backed out the implant, prepared the site and the proper direction and placed the implant slightly more subcrestal and we were able to achieve great stability. Now we basically have a large fenestration and we treated that by doing a slight ridge augmentation. Check out the pics 🙂1
-
