Final Restoration of Two Anterior Implants: A Stability-First Approach with InnerView

Cherilyn Sheets, DDS

5 minute read

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

InnerView Quantifies Implant Stability Before Final Restoration After a 10‑Year Delay

A 40 year old male patient had a root fracture on tooth #7 and severe resorption on tooth #9. Both were terminal. The teeth were extracted and immediate implants were placed and tested with QPD.

Implant #7 had a mobility score of 27 and implant #9 had a mobility score of 19.

Both were well osseointegrated.

The patient disappeared from the practice for 10 years. He reappeared at the practice and wanted to go to final restorations. Four anterior teeth were to be restored.

The implants were tested on impression abutments 10 years after being provisionalized and the results were surprising.

Both implants now tested at a 73 mobility showing poor osseointegration.

Using InnerView to Quantify Implant Mobility Beyond X‑ray Assessment

The InnerView System was used to quantify implant mobility before final restorations. InnerView provides two key metrics:

  • Mobility Score (FDA Cleared in 2023) – Measures overall implant movement which helps in evaluation of osseointegration
  • Normal Fit Error (NFE) – Measures localized mobility within an implant complex (not yet FDA cleared).
Standard periapical radiographs showed well-placed implants with adequate bone support. However, these conventional imaging techniques provide only a static assessment and do not measure functional stability.

While X-rays confirm bone presence, they do not measure functional osseointegration or detect micro-mobility. InnerView provided a quantifiable assessment that revealed hidden stability concerns—offering objective data that traditional diagnostics could not.

Elevated Mobility Scores Indicate Weaker‑Than‑Expected Osseointegration

InnerView testing revealed higher-than-expected Mobility Scores, suggesting weaker osseointegration than anticipated. InnerView Mobility Scores (based on internal data):

  • Ideal Stability: Below 51
  • Moderate Stability: 52-57
  • Weak Stability: Above 57
Both implants measured 73, indicating weaker osseointegration than expected, despite appearing stable on radiographs.
Pre-treatment InnerView® assessment of #7 and #9, showing elevated Mobility Scores of 73, indicating weaker-than-expected osseointegration.

NFE Confirms Bone‑Related Mobility Rather Than Hardware Issues

✔ Low NFE scores indicated well-seated impression abutments with no localized structural issues. This confirmed that implant mobility was due to bone quality, not hardware internal mobility.

This InnerView screen shows that there was no significant mobility between the implant fixture and the impression copings during the testing.

How InnerView Data Shaped the Final Restoration Plan

With objective InnerView data, the clinician had new treatment insights:
  • Delay Final Restorations: Keep provisional restorations longer to allow additional osseointegration.

Or

  • Do Final Restorations:
    • Create an occlusal scheme that does not overload the implants and lighten occlusal load to reduce stress.
    • Provide a protective occlusal guard to mitigate bruxism-related forces.

Why This Matters

Traditional methods—such as manual tapping with a mirror handle or reverse torque testing—are subjective and risk compromising implant stability. InnerView delivers quantitative data using non-invasive technique, removing guesswork and guiding evidence-based treatment decisions.

Knowing that these implants were now not as stable, perhaps due to the patient losing 100 pounds in a non-medically monitored weight loss, additional protections were indicated for these implants to provide for longevity.

InnerView is redefining implant care by providing real-time quantitative data—helping clinicians detect weaknesses before failure occurs.

Key Takeaways: How Quantitative Data Informs Implant Longevity Strategies

  • Early Detection Before Symptoms Appear – InnerView identified osseointegration weakness not visible on X-rays.
  • Minimally Invasive Intervention – Prevented unnecessary risks associated with reverse torque testing.
  • Proactive Implant Monitoring – InnerView supports long-term tracking for early intervention and better clinical outcomes.

A data-driven approach to implant assessment allows clinicians to track implant integrity in real time—enabling early intervention and reducing long-term complications. This methodology ensures more predictable outcomes by measuring the micromobility of the implant and supports long-term patient care.

More Case Studies