Dentistry Review · Published 2026-06-01 · DOI 10.1016/j.dentre.2026.100376
Christopher Rollins
OBJECTIVES: To report a case of spontaneous osseointegration of a previously non-integrated dental implant and explore potential biological mechanisms behind this rarely observed phenomenon. METHODS: A 70-year-old patient underwent dental implant surgery for placement of implants at the sites #22 and #27 for the future retention of a mandibular overdenture. At second-stage uncovery, implant #27 was integrated, while implant #22 was non-integrated and mobile upon attempted cover screw removal. A free gingival graft was performed at the time of the uncovery procedure, but no other interventions, such as bone grafting or curettage of soft tissue surrounding the implant, were performed. Nine months later, at the time of planned implant removal and replacement, reentry revealed complete osseointegration of implant #22, verified by counter-torque testing (35N/cm) and the presence of hard tissue surrounding the implant collar. A healing abutment was placed, and the peri-implant tissues healed with adequate keratinized tissue and probing depths of no more than 3 mm. RESULTS: (If applicable) The previously mobile, non-integrated implant achieved full osseointegration over a nine-month period without additional intervention. This suggests that minor mechanical disruption and prolonged healing may promote spontaneous bone integration in certain cases. CONCLUSIONS: This case demonstrates that initially non-integrated implants may have the potential to integrate given sufficient time and healing conditions. While the exact biological mechanisms remain unclear, factors such as residual bone remodeling, absence of continued micromotion, and disruption of the granulation tissue matrix may contribute to this phenomenon. It is important to note that this outcome is not expected in every case, and the activation and movement that occurred during the first surgery—when implant failure was discovered—could have played a role in the subsequent healing process. Further research is needed to better understand the specific factors that influence spontaneous osseointegration. IMPLICATIONS: While immediate removal of a failed implant is the standard of care, this case raises questions about the role of granulation tissue in the osseointegration process. Instead of complete removal, leaving granulation tissue undisturbed may have potential benefits in certain clinical scenarios. Further research is needed to understand the conditions under which delayed healing and osseointegration can occur, particularly when granulation tissue persists without initial bone contact. These findings may provide insight into alternative healing pathways in implant dentistry.
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Rollins, C. (2026). Spontaneous Osseointegration of a Soft Tissue-Encapsulated Implant: A Case Report. Dentistry Review. https://doi.org/10.1016/j.dentre.2026.100376