Dentaltown August 2020 - 39

On exam, the cover screw of the implant was exposed. There was redness and tenderness
in the area, but no swelling. The implant could be easily moved with a perio probe and a
small amount of pus could be expressed from around the fixture. There was no doubt that
this implant had failed and was infected.
Why did this occur? We can only speculate that failure resulted from inadequate
irrigation, prolonged drill-to-bone contact, excessive insertion torque and/or poor aseptic
technique. All are possible. At this point, the proper plan is to start the patient on antibiotics,
remove the implant, debride the site thoroughly and graft the site so a new implant can be
placed in the edentulous site. That's exactly what I did.
Why is this case noteworthy? There are two issues: First, the training of the dentist.
Although he attended treatment-planning and implant placement courses, it's likely that
the implant course was a "how to place an implant" course, not a comprehensive course that
discussed physiology, biomechanics, aseptic protocol and prosthetically driven planning.
In other words, it taught him how to be a technician, not a clinician. Those concepts are
critically important to know before you place your first implant.

Dentists who
want to learn
to place implants
must not look
to fast-track their
surgical training.

FREE FACTS, circle 7 on card

dentaltown.com \\ AUGUST 2020

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39

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Dentaltown August 2020

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