Unfavorable prognosis of a maxillary implant case

125 Rating(s).

Posted on By Wahib Moussa In Failures

Hello All
Failure,or poor prognosis, a scary word, which means complications, trouble also, means that result is not what we expected. In my humble opinion, failure means you have done your best you have used all the criteria possible for success, and you did it as the book says, but unexpectedly the result, was not, what you expected

This gentleman aged 75 years old , heavy smoker , average oral hygiene and health , presented to our clinic 8 years ago , for fixed prostheses on maxillary implants .
He had a pronounced maxillary ridge which allowed us to insert all on six using punch technique, case was restored successfully
. The patient was not regular in check ups.
He came 2018 with mobility of the fixed bridge, CBCT indicated bone loss and some failure implant.
Treatment was done by removing failed implants, granulation tissue, grafting with a membrane and crystal sinus lift, removal for 3 implants and insertion of four ones, treatment for late loading, patient left with temporary prostheses, resting on 3 implants, loading of the new implants will be done after 6 months .

Thoughts and comments from all colleagues are greatly appreciated.
Wahib Moussa

1- Preoperative , good maxillary arch , planning.
2- Punch procedure.

3- Digital x-ray for implants.
4- Final restoration 2010.

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Hard to see clearly but thanks for sharing. I would have considered removal of ALL the implants and placement of 6-8. The best bone seemed to be in the anterior region where it appears you kept the ailing implants which secured the temporary fixed prosthesis. I would have used that area for placement as the bone quality appeared best in that region. Then continue with plan....just another thought. With reverse torque implant removal kits this is a minimally invasive option which allows you to have no former implants remaining....for potential problems down the road. regards Dr. S


Dr. Salama ,Thank you very much for commenting on on the case, Removal of all implants ,staged grafting and implant insertion Was my plan , had to modify it to match patient expectations And demands .but still, i will re-consider your valuable opinion For the minimal invasive implant removal, in anterior region… Thanks again , with my best kind regards.. Wahib Moussa


À heavy smoker with bad oral hygiene who doesn't keep his recall appointements would definitely jeopardise the best treatment performed.
Serious adjustments òf habits are needed by this patient if he wishes to keep these implants.


Dear D .Farag. Thank you ,four valued comment, I defiantly agree With your opinion ,The patient is an absolute contra indication for implants, unless he seriously try to improve himself. Best regards.