Published online Jun 6, 2022. doi: 10.12998/wjcc.v10.i16.5479
Peer-review started: October 21, 2021
First decision: March 3, 2022
Revised: March 15, 2022
Accepted: April 21, 2022
Article in press: April 21, 2022
Published online: June 6, 2022
Processing time: 224 Days and 3.9 Hours
Implant fracture is one of the most serious mechanical complications of dental implants. Conventional treatment necessitates visibility of the apical portion of the fractured implant, whereas for deep and invisible implant fractures, the traditional trephine method has been ineffective. Surgical removal of the marginal bone to expose the fracture surface would be a time-consuming and extensively damaging procedure. Here, we propose a novel technique to address invisible implant fractures.
A 50-year-old woman was referred to our department with the chief complaint that her right mandibular implant tooth had fallen out 3 mo earlier. Cone-beam computed tomography examination showed an implant fracture with a fracture surface 5.1 mm below the crestal ridge. The patient was treated with osteotomy combined with the trephine technique to expose the surgical field and remove the implant. The invisible fractured implant was successfully removed, with minimal trauma. A modified Wafer technique-supported guided bone regeneration treatment was then administered to restore the buccal bone wall and preserve the bone mass. Six months later, fine regenerative bone and a wide alveolar crest in the edentulous area were observed, and a new implant was placed. Four months later, restoration was completed using a cemented ceramic prosthesis. Clinical and radiographic examinations 12 mo after loading fulfilled the success criteria. The patient reported no complaints and was satisfied.
Osteotomy combined with the trephine technique can be effectively used to address deep and invisible implant fractures.
Core Tip: This article provides up-to-date knowledge regarding the clinical presentation, incidence, risk factors, diagnosis, and management of implant fractures. Conventional treatment requires that the apical portion of the fractured implant be visible. For deep and invisible implant fractures, the traditional trephine method has been ineffective. We developed a novel method of osteotomy combined with the trephine technique that can effectively address deep and invisible implant fractures. Meanwhile, modified Wafer technique-supported guided bone regeneration treatment was conducted simultaneously to preserve the bone mass in the surgical area.