If an implant starts to spin when the healing cap is placed, what should the clinician consider?

When an implant begins to spin upon placement of the healing cap, it indicates that the implant is not securely integrated into the bone, potentially signifying inadequate primary stability or insufficient bone density. The appropriate clinical response is to assess the situation carefully.

Removing the implant may be a necessity if it is confirmed that the implant is failing to achieve primary stability, which is essential for successful osseointegration. In cases where the implant does not hold firm, it could denote that the surrounding bone is unable to adequately support the load, leading to a potential failure in function and longevity.

While options involving the placement of a larger implant or placing the implant deeper appear plausible, they may not address the root cause of the initial instability. If the surrounding bone does not have the necessary density or quality to support an implant of any size, simply increasing the implant size will not rectify the problem. Therefore, focusing on the removal of the failing implant ensures that proper evaluation and treatment can occur, which is fundamental in implant dentistry to achieve long-term success.