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Modified Segmental Osteotomy for Relocation of Malpositioned Implant: Case Report.

da Silva AL, Borba AM, Bandeca MC, Volpato LE, Porto AN, Freitas DL, Borges AH - J Int Oral Health (2015)

Bottom Line: Obtaining a good cosmetic and proper mastication in oral rehabilitation with dental implants are directly linked to the correct positioning of the implant in the alveolar bone.Another option is the modified segmental osteotomy that aims repositioning osseointegrated implant with the surrounding bone.The objective of this case report is to present a case where an implant was severely malpositioned after surgically assisted rapid maxillary expansion, requiring a modified segmental osteotomy technique to reposition it.

View Article: PubMed Central - PubMed

Affiliation: Staff, Department of Oral and Maxillofacial Surgery, General University Hospital of the University of Cuiaba - HGU, Cuiaba, MT, Brazil ; Former MSc Student, Department of Post-Graduation, Integrated Dental Sciences Masters Program, University of Cuiaba - UNIC, Cuiaba, MT, Brazil.

ABSTRACT
Obtaining a good cosmetic and proper mastication in oral rehabilitation with dental implants are directly linked to the correct positioning of the implant in the alveolar bone. The malposition of the implant is a challenge in rehabilitation, which can often compromise the entire process. In cases of severely malpositioned implants, one has the option to remove it or leave it submerged under bone and gums. Another option is the modified segmental osteotomy that aims repositioning osseointegrated implant with the surrounding bone. The objective of this case report is to present a case where an implant was severely malpositioned after surgically assisted rapid maxillary expansion, requiring a modified segmental osteotomy technique to reposition it.

No MeSH data available.


Related in: MedlinePlus

(a and b) Clinical aspect 16 months post-operatively, (c and d) comparison of immediate and 16 months post-operative radiographic records.
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Figure 4: (a and b) Clinical aspect 16 months post-operatively, (c and d) comparison of immediate and 16 months post-operative radiographic records.

Mentions: After clinical and dental casts evaluation, surgical relocation of the malpositioned implant was simulated on a semi-adjustable articulator through a segmental osteotomy. As the prosthesis over the implant was satisfactory, it was planned to use the bracket as a reference to the new position. After a trapezoidal vestibular mucoperisoteal flap (Figure 3a), a 699 drill and a chisel were used to perform two vertical alveolar osteotomies adjacent to the implant, including buccal and palatal bony walls, connected to a buccal horizontal apical osteotomy (Figure 3b). Subsequently, a “greenstick” fracture was done, followed by repositioning of the implant. The bracket on the implant was then connected to the orthodontic arch and stabilized with chemically cured resin surrounding the implant and two adjacent teeth on each side (Figure 3c). The bone gap formed by the movement of the block was filled with halogen bone graft (Geistlich Bio-Oss®, Wolhusen, Switzerland) and the crown of the implant was adjusted to be out of occlusion (Figure 3d). The acrylic resin was removed with 45 days. Radiographic control included the immediate post-operative period, 30, 90 days and 16 months. The patient is currently on a 16 months post-operative follow-up, the bone-implant block shows no clinical or radiographic changes, obtaining the clinical success and patient satisfaction for the treatment performed (Figure 4a-d).


Modified Segmental Osteotomy for Relocation of Malpositioned Implant: Case Report.

da Silva AL, Borba AM, Bandeca MC, Volpato LE, Porto AN, Freitas DL, Borges AH - J Int Oral Health (2015)

(a and b) Clinical aspect 16 months post-operatively, (c and d) comparison of immediate and 16 months post-operative radiographic records.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4588779&req=5

Figure 4: (a and b) Clinical aspect 16 months post-operatively, (c and d) comparison of immediate and 16 months post-operative radiographic records.
Mentions: After clinical and dental casts evaluation, surgical relocation of the malpositioned implant was simulated on a semi-adjustable articulator through a segmental osteotomy. As the prosthesis over the implant was satisfactory, it was planned to use the bracket as a reference to the new position. After a trapezoidal vestibular mucoperisoteal flap (Figure 3a), a 699 drill and a chisel were used to perform two vertical alveolar osteotomies adjacent to the implant, including buccal and palatal bony walls, connected to a buccal horizontal apical osteotomy (Figure 3b). Subsequently, a “greenstick” fracture was done, followed by repositioning of the implant. The bracket on the implant was then connected to the orthodontic arch and stabilized with chemically cured resin surrounding the implant and two adjacent teeth on each side (Figure 3c). The bone gap formed by the movement of the block was filled with halogen bone graft (Geistlich Bio-Oss®, Wolhusen, Switzerland) and the crown of the implant was adjusted to be out of occlusion (Figure 3d). The acrylic resin was removed with 45 days. Radiographic control included the immediate post-operative period, 30, 90 days and 16 months. The patient is currently on a 16 months post-operative follow-up, the bone-implant block shows no clinical or radiographic changes, obtaining the clinical success and patient satisfaction for the treatment performed (Figure 4a-d).

Bottom Line: Obtaining a good cosmetic and proper mastication in oral rehabilitation with dental implants are directly linked to the correct positioning of the implant in the alveolar bone.Another option is the modified segmental osteotomy that aims repositioning osseointegrated implant with the surrounding bone.The objective of this case report is to present a case where an implant was severely malpositioned after surgically assisted rapid maxillary expansion, requiring a modified segmental osteotomy technique to reposition it.

View Article: PubMed Central - PubMed

Affiliation: Staff, Department of Oral and Maxillofacial Surgery, General University Hospital of the University of Cuiaba - HGU, Cuiaba, MT, Brazil ; Former MSc Student, Department of Post-Graduation, Integrated Dental Sciences Masters Program, University of Cuiaba - UNIC, Cuiaba, MT, Brazil.

ABSTRACT
Obtaining a good cosmetic and proper mastication in oral rehabilitation with dental implants are directly linked to the correct positioning of the implant in the alveolar bone. The malposition of the implant is a challenge in rehabilitation, which can often compromise the entire process. In cases of severely malpositioned implants, one has the option to remove it or leave it submerged under bone and gums. Another option is the modified segmental osteotomy that aims repositioning osseointegrated implant with the surrounding bone. The objective of this case report is to present a case where an implant was severely malpositioned after surgically assisted rapid maxillary expansion, requiring a modified segmental osteotomy technique to reposition it.

No MeSH data available.


Related in: MedlinePlus