Literature Bites ????
Bringing you interesting tips from academic literature.
Today’s Case: Implant placed with a severe facial angulation
So, this is the kind of case you look at and say, “Oh hell no. What was the surgeon smoking when this was placed?”
The issue:
These types of cases are impossible to restore. No matter what type of abutment you use, it will not lead to an esthetic outcome.
So 99% of the time, these result in the implant needed to be removed aka “explanted.” This is obviously a tricky proposition because the patient has already paid good money for the treatment and you will now have to convince them that they need additional surgery to remove the implant they paid for and that they might need even additional surgery such as bone grafting.
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[mepr-show if=”loggedin”] Well, these guys published an out of the box treatment for this scenario. I’m not saying its ideal–in fact it seems like it could cause some problems– but the truth is that if the original placement was that bad you are already in some trouble. So I suppose this approach might not be as risk as you’d think!
Here’s what they did:
1. Lateral cuts along the implant so that it can be moved.
2. Grabbed some hemostats and simply rotated the implant to a better position.
3. Added some bone graft and membrane and sutured it up.
This is how the case looked when it was finalized and restored. Not to shabby! ????
Comments: While this method might actually end up causing other problems such as recession or damage to adjacent teeth, it is surely an out-of-the box method to troubleshooting this common problem.
Source: Management of a malposed dental implant in the esthetic zone – PMC (nih.gov) [/mepr-show]
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