The implant at #12 is placed deeper (Fig.4 (arrow), as compared to Fig.2) because of clinically buccal superficial placement.

When a healing screw is placed 1 month postop, it cannot be seated completely with two separate trials (Fig.6,7).  Should we leave it as it is or open up for complete seating?  It appears that the implant is loose. 

The loose healing screw cannot be retightened securely, as there is bone loss around the implant 3 months postop (Fig.10 *).  Failure of the implant is probably due to microvement associated with the healing abutment.  Or the latter is seated too deep, causing bone loss.  Bitewing should be taken.  When a new implant is placed, use a healing screw instead.

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Xin Wei, DDS, PhD, MS 1st edition 09/19/2019, last revision 02/11/2020