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Poor Implant Position
Posted on 09.05.2012 03:11 PM
By Maurice Salama
In Failures
Implant placed with incisionless protocol. Pain in Vestibule months later. Pressure and pain consistant and worsening. Implant is firm and stable without clinical signs of failure. Lateral Ceph and CBCT taken and evaluated. Thoughts? How to prevent? See treatment now updated. Remove, GBR and return and place new implant in corrected position for restoration.
Dr. Salama
CBCT
Lateral Ceph
Surgical view
Surgical view 2
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8 Comments
ALEXANDER SALVONI says on 09.06.2012 01:49 AM
If flapless surgeries requires an experienced surgeon and an adequate bone volume....why we should use a computerized guide? press your finger buccally in the ridge region, so during the drilling process you will be able to feel the fenestration moment if it occurs. To solve, soft tissue graft in the same consultation of implant removal; 40 days later - implant + G.B.R. and final restoration after 4-6 months
George Noesen says on 09.05.2012 03:34 PM
you would think you could see the implant through the gingival tissue as it was being placed.
THEO ODYSSEOS says on 09.05.2012 03:55 PM
remove the implant ,build up the area either with a block or g.b.r. ,new implant new restauration.hopefully this time WITH incision.blades are not expensive...!it is good to see what we do
Band Ditto64 says on 09.05.2012 04:01 PM
I agree. Incredible that placement can be so far misdirected without knowing but this happens especially with incisionless placement, no guides, no CBCT and little experience.
As for treatment, removal for sure. What is incredible is how with so much bone missing the implant was still stable.
Band
EDOARDO VARELA says on 09.05.2012 05:14 PM
Hello Dr. S. implant removal, new implant placement in the correct position, bone regeneration with collagen membrane + platelet rich fibrin. 5 months after final restoration. thanks.
PD: flapless technique should be used by people with considerable experience or strict guidelines.
scot mardis says on 09.06.2012 10:53 AM
How did it get placed so far to buccal?
Robert Burstein says on 09.06.2012 03:51 PM
At least their flossing!
Maurice Salama says on 09.06.2012 04:44 PM
Scot, it's easy to misdirect the implant when placing it without incision. This is an extreme case for sure but I bet there are more like them out there.
Robert, I like the humor about flossing....just trying to impress the fact that little bone to implant contact needed in this case to achieve clinical stability.
Dr. S