Dental implants
Immediate Reconstruction of Failed Implants in the Esthetic Zone Using a Flapless Technique and Autogenous Composite Tuberosity Graft

https://doi.org/10.1016/j.joms.2017.09.005Get rights and content

We describe a technique for immediate reconstruction of bone after removal of failed dental implants in the esthetic region to optimize the esthetic outcome of retreatment. We conducted a study of 16 consecutive patients in whom the bony defect resulting from implant removal was immediately reconstructed with a combined autogenous bone and soft tissue graft harvested from the maxillary tuberosity. After a healing period of 3 months, implants were inserted. At 1 year after placement of the definitive restoration, no implants had been lost, the peri-implant tissues were healthy, the aesthetics scored with the pink esthetic score were favorable, and the patients were satisfied. With this technique, it appears that immediate reconstruction of the hard and soft tissue components with a combined bone–soft tissue graft after removal of an implant is a feasible treatment option, from the perspective of both patients and professionals. It expedites rehabilitation, reduces morbidity, and results in a favorable esthetic outcome.

Section snippets

Technical Note

A cone beam computed tomography (CBCT) scan was made to assess the peri-implant bone volume in the area with the failing implant (Fig 1). In addition, a provisional removable partial denture with an ovate pontic shape was fabricated. Clasp retainers were added to prevent deleterious apicocoronal movement of the provisional restoration.

At 1 day preoperatively, the patients started prophylactic antibiotic therapy (amoxicillin 500 mg, 3 times daily for 7 days, or clindamycin 300 mg, 4 times daily,

Results

The technique was evaluated in 16 consecutive patients (6 men and 10 women; mean age 31.7 ± 4 years, range 19 to 53) with a failing implant in the esthetic zone. In all cases, the CBCT scan revealed extensive bone resorption on the labial side of the implant that had exceeded one half of the implant length. Bone sounding revealed that all patients had an extensive osseous defect of the buccal bone wall side, ranging from 6 to 10 mm from the top of the mucosa. No complications were observed

Discussion

Immediate reconstruction of the soft tissues and bone in the area of a removed implant was associated with favorable implant retreatment outcomes, with no implant loss, good peri-implant health, and satisfactory esthetics.

In the published data, the survival rates after reimplantation at sites in which implants had previously failed were lower than those involving placement of implants in bone in which the implants had not failed.2, 6, 7 The standard approach to remove failing implants often

Acknowledgments

We thank Charles Frink for correcting the English grammar of our report.

References (17)

There are more references available in the full text version of this article.

Cited by (7)

  • Applications of maxillary tuberosity block autograft

    2022, Journal of Esthetic and Restorative Dentistry
View all citing articles on Scopus

Conflict of Interest Disclosures: None of the authors have any relevant financial relationship(s) with a commercial interest.

View full text