Reversal of Osseodisintegration: An Asset for Implantology
Kumari Deepika *
Department of Prosthodontics and Crown Bridge, AIIMS-CAPFIMS, Maidan Ghari, New Delhi-110068, India.
*Author to whom correspondence should be addressed.
Abstract
Background: Implant stability is a critical factor for long term success of implant restorations. Screw loosening in dental implants, a common mechanical complication, can lead to implant or screw fracture due to inadequate occlusal force distribution and potential osseointegration and implant restoration failure. Factors like inadequate preload, inappropriate implant position, variations in screw design, non-passive fit of the prosthesis, tension on the abutment, and occlusal discrepancy can contribute to this problem.
Case Description: The paper presents a case of single implant restoration in which recurrent screw loosening had drastically decreased implant stability as patient not reported in a timely manner for further treatment. It was managed by unloading the implant for 4 months but patient had reported 8 months of unloading after which adequate implant stability was achieved to restore implant function again. Implant stability was checked using a resonance frequency analyzer. In this way mplant failure was prevented by timely intervention.
Conclusion: There is sparse literature regarding the effect of recurrent screw loosening on implant stability. The present report will help in understanding this phenomenon and its management.
Clinical Significance: Success of the implant depends upon the status of peri-implant supporting tissues and biomechanical factors. The effect of micromotion due to disturbance in any of the above factors indicated that the micromotion would induce fibrous tissue encapsulation resulting mobility. Generally if there is mobility, treatment plan is more towards the removal of implant as per Misch classification on implant survival. Despite this subsequent immobilization may lead to a reverse tissue differentiation as presented here that will be beneficial for patients undergoing implant therapy if such undue circumstances took place. Also, removal of ailing implant is traumatic to the patients.
Keywords: Screw loosening, implant stability, implant stability quotient, dental implant, resonance frequency analysis, fretting, screwmentable crown