Insertion torque of a 5x13 mm implant is <20 Ncm (Fig.7).  A 6.5x4(4) mm pair abutment is placed (A), apparently proper for restoration.  Allograft is placed prior to immediate provisional.  The patient complains of bad smell from the site 24 days postop.  When the provisional is removed, the abutment is found to be mobile.  When the latter is removed with local anesthesia, bone graft granules are attached to the socket above the lightly mobile implant.  In fact the latter appears to be stable after a few turns by finger.  A healing screw is placed; the socket is closed with collagen plug and 4-0 Chromic gut sutures.  It appears that a larger implant should have been used to achieve higher torque.  Two months later (3 months postop), the coronal end of the implant is partially exposed.  A 5x4 mm healing abutment is placed.  It appears that the implant is stable.  The implant appears to have osteointegrated 4 months postop (Fig.11).  Impression is taken.

New bone has apparently covered the implant plateau 8 months postop (3 months post cementation (Fig.13 arrows)).  The lower two-thirds of socket have disappeared. Bone density between threads increases 9 months post cementation (Fig.14).

Implant with Low Torque Last Next 1st Year

Xin Wei, DDS, PhD, MS 1st edition 11/11/2016, last revision 12/04/2018