Changes in Bone Density around an implant
This is a section of a pre-operative panorex and while it is not the best of radiographs (it was not taken in my office) you can see that there is some significant damage in the molar bicuspid area. The teeth were extracted in this region and I placed some implants. Actually, I placed three implants and one of them, the most distal, did not integrate. When the implant failed, I replaced it with a second implant, a 10mm IMTEC implant. The radiograph at the left, a periapicle, shows the implant at second stage. It was stable, but radiographically, it did not look too good. I really anticipated that it would also be a failure.
Since the implant was stable, I decided to do a provisional restoration and see what happens. I felt that I had nothing to loose... The radiograph at the left, a section of a panorex taken at 4 months after the provisional restoration was placed, shows the distal implant with questionable bone density around it.... Here is the one year post provisional radiograph showing considerable bone density around the implant. At this point, my impression is that this implant is totally integrated and I can proceed with the final restoration. And, yes, I know that the angulation is not great, but I tend to tip my implants forward as I end up in the posterior region and I guess I did over do it a bit, but it seems like it is working just fine....
These last two radiographs are merely the previous two radiographs inverted to give a better idea of the boney changes. The one year loaded radiograph looks considerably better than the original second stage

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