Conservative Implant Removal for the Analysis of the Cause, Removal Torque, and Surface Treatment of Failed Nonmobile Dental Implants

Abstract

This study was performed to study the effect of implant surface treatment on the cause and removal torque of failed nonmobile implants. Implant explantation was achieved by the application of countertorque at the implant-bone interface. The explantation socket was examined carefully and curetted to remove any granulation tissue. Immediate implant placement was accomplished when primary stability could be achieved. Eighty-one patients were treated according to the described treatment protocol for the explantation of 158 nonmobile implants in the maxilla and the mandible. The patient's mean age was 62 ± 11 years. The main cause of implant explantation was peri-implantitis (131 implants; 82.9%) followed by malpositioning of the implants (22 implants; 13.9%). The explantation of 139 implants at 146 ± 5 Ncm was performed without the need for trephine bur. However, the use of trephine burs to cut into the first 3 to 4 mm was necessary in 19 explantations, and the removal torque was 161 ± 13 Ncm. All titanium plasma-sprayed implants were removed due to peri-implantitis at a significantly lower torque when compared to acid-etched, particle-blasted, and oxidized implants. The postoperative recovery of the patients was uneventful and the conservation of the available hard and soft tissues was successfully achieved. The protocol followed in this study could constitute a real alternative to other traumatic technique for the removal of failed implants and advanced stages of peri-implantitis. The type of implant surface treatment could influence the value of removal torque and the occurrence of peri-implantitis.

Performance of the counter-torque technique in the explantation of nonmobile dental implants

“…The treatment was performed using an implant removal kit (BTI Biotechnology Institute, Vitoria, Spain) that allowed the application of a counter-torque to the bone-implant interface [4]. The decision to raise a flap or not was made according to the surgical needs.…”

“…Although presenting high and acceptable survival rates [1,2], dental implants fail as a consequence of infection (periimplantitis), excessive biomechanical stress, or improper positioning. Different techniques have been described to remove a failed dental implant that include block resection, buccal bone osteotomy, trephine osteotomy, and piezosurgery [3,4]. The application of counter-torque to break the implant-bone interface has been proposed as a safe, efficient, and atraumatic strategy to remove nonmobile implants [4].…”

“…Different techniques have been described to remove a failed dental implant that include block resection, buccal bone osteotomy, trephine osteotomy, and piezosurgery [3,4]. The application of counter-torque to break the implant-bone interface has been proposed as a safe, efficient, and atraumatic strategy to remove nonmobile implants [4]. As a minimally invasive technique, Solderer et al have recommended the counter-torque technique as the first option for the removal of failed nonmobile dental implants [5].…”

The etiology of hard‐ and soft‐tissue deficiencies at dental implants: A narrative review

“…68 Malpositioning as the reason for explantation was reported in 22 (14%) out of 151 implants scheduled for removal. 69 Buccal mucosal recession was observed to be significantly associated with more buccal implant positioning in a prospective cohort study including 30 implants placed in esthetic sites. 70 These findings were corroborated in a retrospective study with 42 single implants in the esthetic zone reporting a significant association of buccal mucosal recession with buccal implant positioning.…”

Balancing microbial and mammalian cell functions on calcium ion‐modified implant surfaces

“…Peri‐implantitis is associated to bone loss and is reported to occur in 6.6%–36.6% of the implants placed . If not anticipated, these infections may require the removal of the contaminated implant and the affected tissues, followed by cleaning and healing of the area before a new implant can be placed . For this reason and given the concern over the development of antibiotic resistance to infection prophylaxis, preventing bacterial surface colonization is of utmost importance.…”