I would like to share with you a clinical situation and know your thoughts about the possible etiology of the problem.
Mr. X attended my office 5 years ago with a partial edentulism in position 26 and 46.
He suffers from Behcet syndrome, disease that involves inflammation of the blood vessels and which causes sporadic sores in mouth and sex organs and caused his blindness 20 years ago.
He is a friend of the family and asked me to replace these posterior teeth.
He also suffers from bruxism, evidenced by a generalized moderate tooth wear and generalized exostosis of the alveolar bones.
I planned and placed two single implants (Straumann Bone Level, Regular platform) in the free-end positions 26 and 46.
Last week he called complaining of movement on the screw-retained crown on implant 46.
Today, I removed the crown and after retightening it again I realized the implant was slightly painful and mobile. Probing after crown removal was normal. No suppuration was present. Just the normal irritation of the marginal mucosa compatible with the movable crown.
This is the periapical x-ray I took.
Since he was in a hurry, I decided to place a healing cap on the implant and control his evolution in 2 weeks.
What do you think the etiology of the problem could be? Could the occlusal overload have broken the osseointegration of an implant that has been in function and stable for 5 years?
The implant in position 26 is asymptomatic and in function.
I will highly appreciate to hear your comments in such a controversial topic.
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