Unintentional Root Fragment Retention in Proximity to Dental Implants: A Series of Six Human Case Reports

Langer, Laureen; Langer, Burton; Salem, Daliah

doi:10.11607/prd.2410

Cited by 33 publications

(31 citation statements)

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“…11 For nine patients, implants were placed unintentionally in contact with residual root fragments. 10 12 13…”

Section: Resultsmentioning

confidence: 99%

“…In addition, the presence of a thick biofilm, calculus formation, and extensive bacterial infiltration on the implant surface were observed. 13…”

Section: Resultsmentioning

confidence: 99%

“…In addition, the impacted teeth are free of periodontal and endodontic inflammation. Further, histological human studies are necessary to confirm these hypotheses, 13 and to explore the healing process in case of structural anomalies. 20…”

Section: Discussionmentioning

confidence: 99%

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Implants Placement in Contact with Dental Tissue: A Potential Paradigm Shift? Systematic Literature Review

et al. 2019

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The aim of this study was to explore the literature for clinical and histological data of an unconventional treatment with implants placement in contact with dental tissue (IPICDT) and to try to clarify its indications and surgical procedure particularities.Relevant publications published until May 2019 on the IPICDT were thoroughly reviewed. Search strategy was developed using a controlled vocabulary combination.Medline’s exploration and manual research identified 397 articles; 15 of these were selected after screening. IPICDT was indicated in three clinical situations: impacted teeth, ankylosed teeth, or residual roots. Clinical and radiological follow-up were satisfied except for implants placed in contact with (and not through) roots. Histological analysis revealed different mineralized tissues formed on the implant surface: cementum on removed implants in human and osteodentin on implants placed in contact with animal teeth dentin and pulp. These findings were described as new concept of implants’ “Mineral integration.”According to this study, the follow-up results of implants placed in contact with roots were controversial. Some implants were stable and others were either removed or kept and disinfected after root extraction because of bacterial infection. However, implants placed through ankylosed or impacted teeth were stable. These findings suggest that the clinicians have to be cautious when applying this unconventional approach. Further studies are recommended to explore its long follow-up. It is also interesting to explore this technique in cases of syndromic dental diseases with several impacted teeth (such as cleidocranial dysplasia; or amelogenesis imperfecta).

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“…11 For nine patients, implants were placed unintentionally in contact with residual root fragments. 10 12 13…”

Section: Resultsmentioning

confidence: 99%

“…In addition, the presence of a thick biofilm, calculus formation, and extensive bacterial infiltration on the implant surface were observed. 13…”

Section: Resultsmentioning

confidence: 99%

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Implants Placement in Contact with Dental Tissue: A Potential Paradigm Shift? Systematic Literature Review

et al. 2019

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“…However, root retention with simultaneous implant placement is rarely feasible due to infection, fracture, or decay of the affected tooth or for strategic reasons. If compromised roots are maintained in close contact with an implant they may cause severe damage to the neighboring implants .…”

Section: Factors Influencing the Degree Of Dimensional Alterationsmentioning

confidence: 99%

Clinical relevance of dimensional bone and soft tissue alterations post‐extraction in esthetic sites

Chappuis¹,

Araújo²,

Buser³

2016

Periodontology 2000

317

261

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The key to achieving pleasing esthetics in implant dentistry is a thorough understanding of the biological processes driving dimensional bone and soft tissue alterations post-extraction. The aim of the present report is first to characterize the extent of bone and soft tissue changes post-extraction and second to identify potential factors influencing tissue preservation in order to facilitate successful treatment outcomes. The facial bone wall thickness has been identified as the most critical factor influencing bone resorption and can be used as a prognostic tool in order to identify sites at risk for future facial bone loss subsequent to tooth extraction. Clinical studies indicated that thin bone wall phenotypes exhibiting a facial bone wall thickness of 1 mm or less revealed progressive bone resorption with a vertical loss of 7.5 mm, whereas thick bone wall phenotypes showed only minor bone resorption with a vertical loss of 1.1 mm. This is in contrast to the dimensional soft tissue alterations. Thin bone wall phenotypes revealed a spontaneous soft tissue thickening after flapless extraction by a factor of seven, whereas thick bone wall phenotypes showed no significant changes in the soft tissue dimensions after 8 weeks of healing. In sites exhibiting a limited bone resorption rate, immediate implant placement may be considered. If such ideal conditions are not present, other timing protocols are recommended to achieve predictable and pleasing esthetics. Socket preservation techniques for ridge preservation utilizing different biomaterials and/or barrier membranes often result in a better maintenance of tissue volumes, although the inevitable biological process of post-extraction bone resorption and bone modeling cannot be arrested. In summary, the knowledge of the biological events driving dimensional tissue alterations post-extraction should be integrated into the comprehensive treatment plan in order to limit tissue loss and to maximize esthetic outcomes.

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“…Nevertheless, recent articles by Nevins et al 22 and Langer et al 23 reported belated implant failures when placed through impacted root remains. Scanning electron microscopic evaluation revealed that the failed implant surfaces were infiltrated by bacterial deposits and calculus.…”

Section: Discussionmentioning

confidence: 99%

Placing Dental Implants through Impacted Teeth to Support a Fixed Partial Denture in a Geriatric Patient as an Alternative to Invasive Extraction Surgeries

et al. 2020

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Multiple dental impactions not associated with craniofacial syndromes are a rare condition and present the dentist with a therapeutic challenge when it comes to performing surgical/restorative treatments in adult patients. This case report describes a geriatric patient with multiple impacted teeth restored by means of two different protocols. In the second quadrant, an impacted tooth was extracted followed by regeneration and placement of an implant. In the third quadrant, implants were placed though impacted teeth for restoration with a fixed partial prosthesis. Placing dental implants through impacted teeth may offer a possible therapeutic option for implant-supported restorations in middle-aged or elderly patients, for whom surgery and orthodontic traction are not possible, and/or patients who refuse to undergo more invasive extraction surgery.

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Unintentional Root Fragment Retention in Proximity to Dental Implants: A Series of Six Human Case Reports

Cited by 33 publications

References 0 publications

Implants Placement in Contact with Dental Tissue: A Potential Paradigm Shift? Systematic Literature Review

Implants Placement in Contact with Dental Tissue: A Potential Paradigm Shift? Systematic Literature Review

Clinical relevance of dimensional bone and soft tissue alterations post‐extraction in esthetic sites

Placing Dental Implants through Impacted Teeth to Support a Fixed Partial Denture in a Geriatric Patient as an Alternative to Invasive Extraction Surgeries

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