Repositioning a prosthetically unfavorable implant by vertical distraction osteogenesis

Prosthetically unfavorable implant positions challenge patients and restorative dentists. Surgical correction of malpositioned implants may be an alternative technique for esthetically and biomechanically acceptable prosthetic restorations. This case report describes an alveolar distraction technique used to coronally reposition a dental implant and the 3-year results in the maintenance phase. To our knowledge, long-term follow-up of this method of correction is unprecedented. The present case report describes the repositioning of an apically positioned and fully osseointegrated implant at the right maxillary canine region using an alveolar distraction technique. Distraction was performed at 1 mm per day and ended when the implant moved 6 mm coronally. After a consolidation phase of 8 weeks, an implant-supported fixed prosthetic restoration was performed. Healing was uneventful after removal of the distractor. During the 3-year follow-up, the implant was fully functional with minimal probing depths, negligible signs of inflammation, and no further bone loss. This intervention illustrates the promise of an alveolar distraction osteogenesis procedure for vertical repositioning of apically positioned implants. This technique also provided soft and hard tissue remodeling to obtain an esthetic and stable restoration.