In a clinical case letter published in the Journal of Oral Implantology, Dr. Nick Augenbaum and Dr. Elliot Koschitzki explain their evaluation and treatment of a failed dental implant from another dentist and the importance of malposition and resulting esthetics to the overall outcome and success. Achieving a natural-looking and functional implant-supported restoration in the front teeth is challenging for most cosmetic dentists, who are tasked with ensuring the implant’s titanium post is correctly positioned to fuse with the bone. If the positioning is off by the slightest degree, as was the case with this 25-year old patient, implant failure and poor esthetic outcome are common.
According to their case description, the patient, who had received a single tooth implant 2 years prior from another dentist, complained that his front tooth was too short and chipped. He had no pain or discomfort, but was not pleased with the appearance of his smile.
An X-Ray taken by Dr. Nick and Dr. Elliott showed that the patient had lost more than 50 percent of his jaw bone around the implant site. They also noted poor emergence profiles of the crown, which “had a very short clinical height” compared to adjacent teeth. After removing the chipped crown and abutment, it was noted that the implant platform was in a supergingival position, which likely contributed to its failure.
They also obtained X-Rays from the original dentist, which helped confirm that the first bone graft was not successful because the interdental bone was inferior to the implant platform.
They ultimately determined that the implant was non-restorable and that the patient would need extraction, a bone graft, a new implant and a new custom restoration. In the process, Drs. Nick and Elliot harvested soft tissue from the patient’s palate, which was then sutured to the implant site for optimal results.
After radiography indicated that osseointegration (bone fusion) had successfully taken place, and a temporary restoration was placed, the acrylic crown was adjusted and sculpted over a two-month period, ensuring the gingival margin was in correct relation to the implant. Once proper fit and occlusion were established, a custom-made abutment was placed on the implant post and secured.
The results of the dental implant replacement proved completely satisfactory to the patient, who was pleased with the appearance and function of his replacement tooth.
Malposition and prosthetic failure are risks with any dental implant procedure, which is why it’s imperative to seek a dentist with extensive surgical training in implant placement, bone regeneration, and bone grafts.
Whether you’re in need of a single implant or a full set of replacement teeth, you’re in good hands at Long Island Implant & Cosmetic Dentistry, where patients can enjoy the benefits of beautiful dental implants in just one day.
To schedule a free consultation with experienced Suffolk County dental implant specialists, call us at (631) 296-0588.
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