The vast majority of dental implants succeed, providing patients with the practical and functional benefits afforded by natural teeth. However, achieving an aesthetic implant-supported restoration in the maxillary anterior region can be exceedingly challenging. This fact is illustrated in a case study authored by Dr. Elliot Koschitzki and Dr. Nick Augenbaum, and published in the December 2014 edition of the Journal of Oral Implantology.
Implant malposition caused prosthetic failure
The study presented a case in which the doctors restored a 25-year-old patient’s dental implant that had been incorrectly positioned by a previous dentist and thus delivered a poor aesthetic outcome. Dr. Nick and Dr. Elliot outline the various facets leading to implant failure, which in this case was attributed to a slight inversion in the apical–coronal position.
Dr. Nick and Dr. Elliot note that the patient’s bone graft was compromised because the interdental bone was inferior to the implant platform. While the patient in the case study experienced no pain or discomfort, he was unsatisfied with the appearance the dental implant, which is a hallmark of failure. According to the American Dental Association C Council on Dental Material Instruments and Equipment, patient satisfaction with implant aesthetics is one of the criteria used to mark success.
Restoring proper aesthetics for patient satisfaction
In order to optimize aesthetics, it was determined that the prosthetic had to be extracted and replaced with a new, properly positioned implant and custom-made crown following another bone graft. Dr. Elliot and Dr. Nick were able to restore the failed implant to the patient’s satisfaction, paying special attention to the visual result of the implant.
You can read the entire case study (Vol. 40, No. 6, pp. 751-754), entitled “Replacement of an Implant and Prosthesis in the Premaxilla Due to a Malposition and Prosthetic Failure: A Clinical Case Letter,” here. Warning: graphic photos depict the full implant removal and restoration process.