Removal of a failed integrated implant fixture

Situation

- 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.

Treatment Planning

Removal of both implant #31 and #41 was planned.

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Cement retained bridge was removed from the implant abutments.

Abutments were removed from the fixtures.

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

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

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

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

#31 implant was also removed leaving intact bony walls.

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

Postoperative periapical view.

Click on the image to see clinical video.