Implants · patient case question
On the day of implant placement, what must be achieved for osseointegration to proceed?
Patient case: Implant Maintenance Problems
demo: 57-year-old female
chief: “The gums around my implants bleed and food gets stuck underneath.”
history: Edentulous maxilla restored with an implant-supported fixed prosthesis 3 years ago. Former smoker.
meds: None
findings: Bleeding on probing and erythema of the peri-implant mucosa at three sites. Radiographs show no bone loss beyond the initial remodeling. The intaglio of the prosthesis is concave, with food packing at the tissue interface.
Show answer and explanation
Correct answer: B. Primary stability
- A. Radiographic fill is an outcome of healing over months, not a day-of-surgery requirement.
- B. Correct. Primary (mechanical) stability at placement prevents micromotion during healing; excessive micromotion produces fibrous encapsulation instead of bone apposition.
- C. Immediate loading is an option in selected cases, never a requirement, and depends on having achieved primary stability first.
- D. Keratinized tissue aids long-term maintenance but is not the determinant of osseointegration.