Implant failure with spontaneous rapid exfoliation: case reports

The predictability and success of endosseous dental implants has secured their place as a standard treatment modality. Nevertheless, a small number of implants will fail regardless of operator experience or clinically recognizable cause. This article presents two cases of early failure of two-stage dental implants manifesting in a spontaneous and rapid exfoliation.

Two healthy adult male patients received single-tooth, machined titanium implant fixtures during uncomplicated stage-one surgical procedures.

After an uneventful early postoperative healing phase, both patients returned during the 4 to 6 week time period with failing implants. Clinical examination in both cases revealed the exfoliation of a fixture from the edentulous area with varying signs of soft tissue reaction in each instance. Radiographs revealed osteotomy sites along with the coronally migrating fixtures, with one of the exfoliated implants accompanied by apparent perifixtural radiolucency. In both cases, the implant fixtures were removed digitally without anesthesia. Subsequent medical follow-up was noncontributory, and ultimate healing was uneventful in both cases. Two separate attempts in the mandibular right second premolar region of one patient ended in similar failures despite the successful osseointegration of an identical fixture on the contralateral side.

Few cases of early exfoliation of dental implants have been reported in the literature. Although the exact etiology of the early fixture loss in these two patients is unclear, the description of these cases can add to the published knowledge of dental implant failures and potentially lead to the uncovering and prevention of their causative mechanisms.