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Unconventional Implant Placement IV. Implant Placement Through Impacted Teeth to Avoid Invasive Surgery. Long-term Results of 3 Cases

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Unconventional Implant Placement IV. Implant Placement Through Impacted Teeth to Avoid Invasive Surgery. Long-term Results of 3 Cases

Davarpanah Mithridade et al. Open Dent J.

Abstract

This paper presents the long-term data of patients that have been treated with an unconventional implant placement protocol to avoid an invasive surgery when edentulism was caused by an impacted tooth. In 2009, the follow-up of this unconven-tional protocol was 2 to 3.5 years; this article documents now the long-term 5- to 8-year follow-up of 3 patients and 5 im-plants. Over this period of time, implant stability was maintained without complications. This unconventional protocol opens intriguing possibilities; however, more patients with long-term follow-up are warranted before endorsing it in routine appli-cation. Nonetheless, it might suggest that there is still room to revisit one of the leading concepts in dental implantology.

Keywords: Impacted canine; implant-bone interface; implant-dentine interface; non-invasive surgery; paradigm shift..

Figures

Fig. (1)
Fig. (1)
Patient # 1. a) Panoramic radiograph with the unerupted canine. b) Radiograph showing the drilling through the impacted canine. c) Radiograph after removing the drill. Reduction in radio-opacity is related to the removal of dental tissue. d) Implant placement after removing the mobile fragment of the crown on the mesial side. e) Periapical radiograph at the 8-year control. f) Vestibular clinical view at the 8-year control. The papilla length is similar to the adjacent natural teeth.
Fig. (2)
Fig. (2)
Patient # 2. a) Preoperative tomodensitometric examination displaying a 3D reconstruction and a transverse section at the impacted ectopic horizontal premolar. The impacted tooth is in the middle of the mandible just beneath the root of the failing teeth. b) Localisation of implant WHO # 32 (ADA # 23) and corresponding transverse section of the tomodensitometric examination at the 8-year control. c) Localisation of implant WHO # 33 (ADA # 22) and corresponding transverse section at the 8-year control. d) Localisation of implant WHO # 34 (ADA # 21) and corresponding transverse section at the 8-year control. e) Axial section of the tomodensitometric examination at the 8-year follow-up. Note the distinct position of each implant in contact with the various parts of the impacted premolar, the cuspid of the crown, the crown and the root. No specific deleterious radiographic feature could be observed.
Fig. (3)
Fig. (3)
Patient # 3. a) Pre-operative panoramic radiograph with the radicular part of the canine. b) Post-operative radiograph of the implant encroaching the root. c) Flattening the distal part of the root of the impacted canine to accommodate the abutment. d) Flattened distal part of the root before suturing over the abutment. e) Periapical radiograph of the implant incroaching upon the canine at the 5-year control. f) Panoramic radiograph of the implant-supported prosthesis at the 5-year control.

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