[Removal of fractured cylindrical implants]

Area of Science:

• Dental Implantology
• Prosthodontics
• Oral Surgery

Background:

• Implant fracture is a rare but significant complication in dental restorations.
• It necessitates specific treatment involving surgical removal and prosthetic plan modification.
• Maxillary overdentures supported by osteointegrated implants are identified as high-risk clinical situations.

Observation:

• A case study involving a fractured maxillary overdenture supported by two osteointegrated implants is presented.
• Epidemiological, etiopathogenic, diagnostic, and therapeutic aspects of implant fracture were analyzed based on recent literature and the observed case.
• Major etiologic factors include defects in implant design or material and physiological or biomechanical overload.

Findings:

• Three therapeutic options are detailed: 1) implant removal, replacement, and prosthesis refabrication; 2) prosthesis modification with fractured implant in situ; 3) fractured implant modification and partial prosthesis refabrication.
• Diagnostic criteria for implant fracture are described.
• Three surgical removal techniques (block-section, vestibular, occlusal approaches) are illustrated, with emphasis on trephine drill use for ostectomy to minimize bone loss.

Implications:

• Understanding risk factors and diagnostic criteria is crucial for managing implant fractures.
• The choice of therapeutic option depends on the clinical situation and surgeon's preference.
• Minimally invasive surgical techniques, like using a trephine drill, can help preserve bone during fractured implant removal.