How to remove a fractured implant?
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Knowing how to remove a fractured implant is essential in modern implantology, especially with the increasing number of implant placements. Unfortunately, some implants fail due to excessive forces they were not designed to withstand. Two common causes include poor diameter selection and inadequate prosthetic planning.
Fractured Implant
Causes and complications of implant fracture
When an implant is exposed to overload, it may lead to abutment loosening. If unresolved, this can progress to screw fracture or, worse, connection breakage. When the implant itself fractures, removal becomes mandatory and often very complex.
Although removal kits exist, most rely on the internal connection of the implant. If the fracture involves this part, even those systems become useless.
Clinical case: fracture and alternative approach
Today we present a patient with a fractured implant wall and destroyed connection, located in highly cortical mandibular bone. A trephine seemed a possible option, but it would require removing a large volume of bone—5–6 mm in diameter and 10 mm deep. This would lead to a significant defect and delay the overall treatment with additional grafting.
Instead, we opted for a bone window approach using thin osteotomies and a microsaw.
Bone window and Split Bone Block technique
We removed the buccal bone wall to access and extract the implant atraumatically. Then, we placed a new implant in the same site. To restore the buccal wall, we followed the Split Bone Block technique by Prof. Khoury: we split the bone window into two thin blades, fixed one with microscrews, and filled gaps with particulate bone.
After just 16 weeks, we performed the second-stage surgery. At that point, bone healing was excellent, and we referred the patient for the final prosthetic restoration.
🦷 Below, you’ll find all the clinical images. Hope you enjoy this case!
To solve the case in one single surgery and as atraumatically as possible, we choose to perform a bone window with very thin osteotomies.
Mandibular buccal bone wall is removed with the use of the microsaw (Creating our window approach into the mandibular medular bone where the fractured implant is located) once removed, we can extract the fractured dental implant and place another implant in the same site.
Finally, it will only be necessary to adapt this removed buccal window. To do so, we are going to follow the Split Bone Block tehnique philosophy, proposed by Professor Fouad Khoury.
Based on preventing long-term resorption and accelerating bone vascularization We are going to Split the bone block (Bone window) into two thin bone blades, fixing one of them with two microscrews, rebuilding the bucal missing wall and filling all gaps with particulated bone.
We only wait 16 weeks to perform the second stage surgery or placement of the healing cup. At this moment you can see the great aspect of the bone surrounding the implant, this is when we send our patient to the referral prosthodontist to elaborate the final prosthetic restoration. Xray of the final restoration can be seen in the last picture.
Here you have all pictures of the process, hope you like it!
