Explantation of Failed #46 Implant with Immediate Implant Replacement and Bone Grafting
Surgical Procedure
Chief Complaint
Dislodged implant crown at #46 region.
Clinical Findings
Clinical examination revealed:
Dislodged implant crown at #46
Fractured abutment screw and abutment neck
Prosthesis not salvageable
Very tight fractured screw component
Evidence of heavy bruxism and clenching
Generalized occlusal wear noted on remaining dentition
CBCT taken for assessment of implant condition and replacement planning.
Treatment Plan
Surgical explantation of failed implant at #46
Immediate implant placement at the same site
Bone grafting to support implant stability and regeneration
Risks and procedural steps explained.
Implant position planned using CBCT assessment.
Patient understood and consent obtained prior to procedure.
Pre-operative Assessment
CBCT evaluation performed to assess:
Implant integrity
Surrounding bone condition
Relationship to inferior alveolar nerve
Suitability for immediate implant replacement
No contraindications identified for explantation and immediate placement.
Anesthesia
Local anesthesia administered prior to surgery.
Surgical field prepared and draped under sterile conditions.
Surgical Procedure
Procedure performed as follows:
Crestal incision made
Buccal and lingual flaps elevated
Failed implant at #46 trephined and removed in total
Implant site prepared using sequential implant drills and osteotomes
Immediate implant placed (Dentium Superline 7.0 mm × 8.0 mm)
Healing abutment placed
Bone grafting performed using synthetic graft material
Flap released for tension-free closure
Primary closure achieved with sutures
Hemostasis confirmed
Clinical photographs taken
Post-operative CBCT performed.
Post-operative Assessment
Post-operative CBCT confirmed:
Implant positioned appropriately
Good alignment achieved
Inferior alveolar nerve not involved
Procedure completed uneventfully.
Patient satisfied with outcome.