Removal of a failed integrated implant fixture

허영구 원장님 Dr. Heo

Author
Dr. Young-Ku Heo, DDS, MDS, PhD

Director of Global Academy of Osseointegration
Seoul, Korea



- Advanced periimplantitis and significant bone loss around implant #31 and #41.
- Severe bone loss to the apical third around implant #31 and #41.
- Gingival recession on implant #41.
Removal of both implant #31 and #41 was planned.
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Cement retained bridge was removed from the implant abutments.

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Abutments were removed from the fixtures.

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A fixture remover screw was screwed into the implant fixture and tightened to 80Ncm (less than 80Ncm is recommended) using the torque wrench.

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A fixture remover that fits to the coronal part of the implant was selected and screwed on the removal screw in counterclockwise direction.

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The failed implant #41 started to come out as a counter-torque reaching 350Ncm was applied with copious irrigation. Surrounding bone has not affected.

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350Ncm of reverse-torque was applied on #31 implant with copious irrigation using the fixture remover.

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#31 implant was also removed leaving intact bony walls.

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The sites following atraumatic implants removal. Bone augmentation after a month of tissue healing was planned.

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Postoperative periapical view.

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Click on the image to see clinical video.

What do you think is the best method to remove a failed integrated implant? This case presents minimally invasive technique of removal procedure of periimplantitis affected implants using a counter-torque ratchet.

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