Early Detection of Implant Instability in a 75-Year-Old Patient

Howard Golan, DDS

5 minute read · March 18, 2025

Clinical Snapshot and Overview

Dr. Howard Golan, DDS, runs a family dental practice in Nassau County, NY, with a focus on integrating advanced diagnostic technologies. His practice emphasizes long-term patient care and early detection of implant and tooth complications.

The information in this case study pertains to future capabilities, currently under clinical evaluation – Not yet FDA cleared.

Routine Recall Reveals Subtle Risk

A 75-year-old male presented for a routine hygiene visit. Though asymptomatic, a loose crown on #13 raised concerns. Radiographs and visual exam confirmed mobility but did not explain the underlying issue threatening implant stability.

With InnerView, Dr. Howard Golan detected an early-stage implant complication that was otherwise undetectable. This case demonstrates how InnerView’s quantitative percussion diagnostic technology can reveal implant instability before catastrophic failure occurs.

Initial Clinical Findings

Patient Condition

  • Loose #13 with no symptoms
  • Poorly adapted crown on #13
  • Generalized perio inflammation & bone loss tooth #14
  • Slight bone defect with calculus on #14

Initial Treatment Plan

  • Splinted PFM crowns on #12 and #13 to stabilize mobility
  • Implant maintenance for #14

InnerView Detects Hidden Instability at #14i

During the evaluation, InnerView measurements confirmed the expected mobility of #13 but also uncovered an unexpected finding—implant instability at #14i.

  • InnerView NFE Score for #14i: 162 (Extremely high, indicating structural instability in the implant complex)
  • Multiple peaks in the diagnostic readout suggested an underlying issue before clinical symptoms appeared

Overall mobility scores were in the normal ranges.

Initial NFE Test Result

The NFE score for #14i was very high.

Intervention Guided by InnerView

Dr. Golan removed the screw channel composite and re-torqued the abutment screw on #14i to 32NCM. Following this minor adjustment, a second InnerView measurement revealed:

  • Significant reduction in NFE scores
  • Restoration of implant stability
  • Prevention of potential implant failure
This result strongly suggests that the abutment screw was in the early stages of loosening, and had it gone undetected, the patient could have faced costly implant failure and irreversible bone loss.
NFE Test Results Post Adjustment

Key Takeaways

  • InnerView identified hidden implant instability not visible clinically or radiographically

  • NFE data guided a simple, minimally invasive correction

  • Objective metrics validated restored implant stability

  • Routine InnerView monitoring supports proactive implant maintenance

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