holy crap, is that what i think it is?

so i'm ready to restore my next implant case, a really great one because it's tooth #11 and we've been bleaching him, so i'm all over that procera thing and i'm very excited. implant was placed in a one stage surgery under IV sedation, as this patient has a history of syncopal episodes in the dental chair (and i REALLY can't wait to do the other two lower PFM crowns that are in the treatment plan - i'll just have the paramedics wait by the door).

he's a very nice guy, so we make our chit-chat and i seat him and i have my armamentarium ready to go. it's an anterior tooth, so i'm expecting that the surgeon placed the implant a little further below the crest of bone so we get a nice collar of gingiva to help obtain a aesthetic emergence profile for the crown. now, these healing caps are placed good and tight, so i always tell the patient to expect a little pressure when i'm de-torquing the thing.

"don't worry, the implant isn't going anywhere."

so i use my driver and move counterclockwise, and the patient says, "yikes!" and starts to sweat, his color a little off, too.

"are you okay?"

"yeah, just really dizzy."

crap. so we put him in trendellenberg, give him some cold water, and place a cool, damp washcloth on his head. i'm freaking out, i've never had a patient pass out on me, and i really don't feel like utilizing the info i've learned in my medical emergencies course. not today, anyway.

"wow, that feels great," in response to the cold compress. "you can go ahead, now."

so i'm gently twisting, turning this healing cap and loosening it and i'm thinking, wow, i've never gotten this much resistance before, must be really tight! and i'm turning and turning and finally out it comes, and it's gray and awfully long and i'm like, hey, i've never seen a healing cap like that...wait a minute. after the double take, i realized what it was.

the implant was right there on the tray! i was pulling out the actual fixture!

"um, mr. poor patient, a minor complication here, seems like your implant has fallen out. i'm going to call dr. perio's office and find out what we can do for you."

"yeah, that seems like a complication to me."

we put him in a taxi, given his near-syncopal episode today, and he was accompanied by my office manager and his un-integrated implant. i'll be seeing him in 6 more months, hopefully.

i guess there's a first time for everything, right? i nearly shit a brick today!