Learning and feeling comfortable placing implants can be a fun process, but what happens if you have an implant fail? Or you just see a failure in your office that someone else placed?
As a periodontist I get a lot of patients referred to me when an implant needs to be taken out. Most of these are implants that have been in for years, but the patient fell off maintenance and then one day comes in like this.
This patient in particular had this implant placed about 8 years ago in another state. She started up with a new dentist who took X-rays and then sent her over.
Oof.
But sometimes implants will fail. There’s peri-implantitis, or a fracture, and they just need to be removed. Many times these implants are NOT mobile (because it’s never that easy lol). I’ve tried a bunch of ways to remove them and now I have my favorite go-to methods and tools.
1.) Zimmer Biomet Implant Removal Kit
I LOVE this kit. I really feel like it works like a charm, and it is the best way to preserve whatever bone is still there. There are great YouTube videos that show you each step but here’s the gist. By assembling the pieces into and on top of the implant, you are able to torque the implant out. You can apply up to 400Ncm to torque the implant out. This is GREATEST in peri-implantitis cases where the implant has lost some support. I’ll also add this can be used with any implant and does NOT have to be a zimmer biomet implant.
2.) #2 round bur, surgical length
Okay okay, so you tried option 1 and that thing is not moving. Or the implant is fractured to the point where you can’t get those pieces stable on the implant. In that case, I like to take the #2 round bur (you definitely need the surgical length) and trough around the implant, CLOSE to the implant, deeply. Then you can use typical elevators/forceps to take the implant out. (This is after raising a full thickness flap with good visualization the implant)
I’m sure that some people like to use a trephine instead from the get go. In my personal experience, they are SO aggressive. You have to make sure you have a size larger than the implant so you can get it all the way down, and I find you take WAY more bone off than doing the same things with a round bur where you can stay closer to the implant. Or sometimes you only need to remove a certain amount to get the implant out.
Sometimes I may still use a trephine bur (like the ones below), but it isn’t my go to.
I’d love to hear what you think is the most efficient way for you to remove implants, and any questions you have for me!
I’m on your team,
Joelle
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