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Implant repositioning with segmental osteotomy.
Allan Bokobza1, Ludovic Lauwers2, Gwénaël Raoul3
1Univ. Lille, Department of Oral and Maxillofacial Surgery, CHU Lille, F-59000 Lille, France.
Journal of Stomatology, Oral and Maxillofacial Surgery
|March 11, 2021
Summary
This study demonstrates that segmental osteotomy can effectively reposition dental implants for atrophic premaxilla restoration. This technique achieves favorable function and aesthetics, even with initially unsuitable implant placement.
Area of Science:
- Oral and Maxillofacial Surgery
- Dental Implantology
- Orthognathic Surgery
Background:
- Atrophic premaxilla presents challenges for dental implant reconstruction.
- Conventional implant placement may be compromised by inadequate bone structure.
- A novel approach involves repositioning implants to optimize anatomical and functional outcomes.
Purpose of the Study:
- To evaluate a pioneering technique for atrophic premaxilla restoration using implant repositioning.
- To assess the anatomical and physiological suitability of repositioned implants for occlusal function.
- To leverage available bone mass through initially suboptimal implant insertion followed by osteotomy.
Main Methods:
- Surgical intervention on 3 patients (14-20 years old) requiring partial implant-prosthetic rehabilitation.
- Placement of 13 dental implants, primarily in the maxilla (85%), within native bone.
- Subsequent repositioning of implants using segmental osteotomy.
Main Results:
- Achieved a biomechanically favorable implant-to-tooth ratio (80%).
- Attained 100% success in functional criteria, including occlusal relationships and midline positioning.
- Obtained 100% aesthetic success with non-apparent screw access holes, despite some gingivo-alveolar alterations.
Conclusions:
- Implant repositioning via segmental osteotomy is a viable method for atrophic premaxilla restoration.
- Addresses challenges related to initial implant angulation and bone availability.
- Peri-implant aesthetic concerns are common across premaxilla reconstruction techniques; further validation with larger cohorts is recommended.
