Immediate repair of bony defects in the posterior mandibular region following removal of a fractured implant: a feasible treatment?

Int J Oral Maxillofac Surg. 2024 May;53(5):430-435. doi: 10.1016/j.ijom.2023.11.007. Epub 2023 Dec 6.

Abstract

The aim of this study was to assess whether immediate bone reconstruction after removal of a fractured dental implant in the posterior mandible provides a sound base for implant replacement, with a favourable treatment outcome and high patient satisfaction. Eight consecutive patients with a fractured implant neck were included. The implant was removed via osteotomy, following which the site was immediately repaired with a mixture of autogenous bone and bone substitute. After a 4-month healing period, sufficient bone and favourable soft tissue conditions were present, allowing implant placement with adequate primary stability. After a further 3 months, the implants were restored with an all-ceramic restoration. Patient satisfaction, the aesthetic outcome, complications, and postoperative morbidity were assessed using standardized clinical and radiographic examinations up to 5 years after crown placement. No implant failures were observed during the follow-up. Plaque accumulation, the presence of calculus, bleeding tendency, and peri-implant inflammation indices were low, indicating healthy peri-implant conditions. The mean marginal bone level change at the 5-year follow-up was - 0.17 ± 0.46 mm. All patients reported a high level of satisfaction (mean overall score 9.3 ± 0.5). In conclusion, immediate reconstruction of the hard tissue after removal of a fractured dental implant is a viable treatment option. This approach facilitates rehabilitation, reduces morbidity, and leads to favourable aesthetic outcomes.

Keywords: Dental implantation; Dental implants; Dental restoration failure; Humans; Mandible.

MeSH terms

  • Alveolar Bone Loss* / surgery
  • Dental Implantation, Endosseous / adverse effects
  • Dental Implants*
  • Dental Implants, Single-Tooth*
  • Dental Prosthesis, Implant-Supported
  • Dental Restoration Failure
  • Follow-Up Studies
  • Humans
  • Immediate Dental Implant Loading*
  • Mandible / surgery
  • Treatment Outcome

Substances

  • Dental Implants