Yesterday I had a patient with failed second molar of right mandible that was extracted one year before.We decided to place a Nobel Replace tapered groovy 4.3 — 10 mm. First I used the pilot drill 2mm and when I reached the final drill for 4.3 (yellow) I started to insert the implant with the motor at 25 ncm. I had checked the walls of the implant bed and the bottom with a depth indicator and xray. Also I had distance from mandibular canal 2 mm.

However, when I reached at the 2/3 of the height of the implant I felt the implant screwing-falling to the bottom of the bed…like falling when you are in a lift..! No primary stability!! It was a very big surprise for me since I have experience in oral implantology. But it was my first time using the Nobel System. Usually I use Xive, 3i Biomet and MIS.

I decided not remove the implant and I tried to screw the cover screw and it was screwed with the implant (like the whole system implant-screw was spinning…) I placed sutures and I pray now for a secondary stability while osseointegration process.

What is your opinion? Did you have any similar cases with the Nobel system?

By the way, I was thinking that the soft bone was the cause, and I had to stop drilling with the 3.5 drill, but the protocol says that the final drill had to be the yellow for a 4.3mm diameter implant in any case of bone, and in case of dense bone to use further tapping drills. Thoughts?

Our goal at OsseoNews.com is to help expand knowledge of dental implants and related dental fields by offering interactive online education and communication tools.

© 2021 OsseoNews, Inc. All rights reserved.