Dental implants are a successful and predictable tools to replace missing teeth. If planned and executed with precision the risk of failure can be reduced to a minimum.

Among risk factors for implant placement one could list patient related risks and technique related risks. Among patient related, uncontrolled systemic diseases (diabetes), smoking and poor oral hygiene are the mayor risk factors.

As far as technical, malposition and mechanical parts breaking may lead to implant failure or disease.

We report a case where the implant on the central area of the upper jaw of the patient was placed partially outside the bone volume available.

Since the patient was already missing a tooth, a new plan was offered to replace it along with extraction of the failing implant and simultaneous replacement with a correct-positioned one.

Due to lack of bone, an augmentation was performed simultaneously in order to prevent future resorption of existing bone.

It has to be noted that the use of modern tools to explant existing implant and the use of digital implant planning with surgical computer guide, helped the surgeon to provide a correct and precise placement with a decrease of technical risks of failure.

– By Dr. Lorenzo Mordini

Fig 1 a, b. (below). Frontal and lateral view of the implant (crown right to the space) and missing tooth.

Fig 2.(below). Implant guided placement after malpositioned implant extraction with dedicated tools.

Fig 3 a, b.(below). Healing after implant placement and bone grafting.

Fig. 4 a, b (below). Radiographic image of implant (white image) that is outside the bone volume. In green, the digital plan of the new implants.

Fig 5 a, b (below). Software combining 3D radiograph with digital implants in order to create surgical guide.

Fig 6. (below). Radiographic image after placement of two new implants‚Äč

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