Failed Implant: Comments on this Case?
This 34 year old Male presented to our office for surgery. The upper central incisor teeth were traumatized in an accident and he had the left central avulsed and reimplanted. This has now failed and we plan to restore the upper right central incisor implant. Patient is currently wearing a single removal partial denture. The dental implant was placed in a hospital in South Africa about 15 years ago, but the patient did not return for restoration. I suspected that this was a Branemark implant but Nobel has confirmed that it is not the case. Can anybody help identify this implant? Also any further comments on this case and any treatment planning suggestions would be valuable? Thank you all for your help in advance.
(click for larger image)
![]](https://osseonews.nyc3.cdn.digitaloceanspaces.com/wp-content/uploads/2012/07/dd.jpg)Periapical Radiograph
9 Comments on Failed Implant: Comments on this Case?
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peter fairbairn
7/4/2012
Might be a Southern ( External Hex ) but not a user so not sure . They way forward would be to remve the root and use the Implant for a temporary cantilever . After 3 weeks ( soft tissue closure raise a flap , curretage the site and place Implant with Bio-absorbable graft and load in 3 months.If thin Bio-type move tissue from palatal aspect on exposure .
Regards
Peter
osseonews
7/5/2012
There are two websites that are useful in identifying implants. They are: osseosource.com and whatimplantisthat.com
Itawil
7/5/2012
Email Darwin from implant direct. He spot on when it comes to identification. It is defintely external attachment.
Dr. Alex Zavyalov
7/5/2012
If the dentist considers that the implant is failed and It’s going to be extracted, why he wants to determine this implant brand (?) There are a few treatment plans here which depend on patient’s possibilities.
dr. np
7/8/2012
Thank you all kindly for your responses.
Dr Fairbairn was correct, this is a Southern Implant, the company have confirmed this.
Just to clarify, the implant has not failed (or at least I cannot confirm that yet, as I have yet to expose it). It is the adjacent central incisor tooth that has failed.
as the patient has a very large anterior open bite, I plan to extract the failed tooth, and replace it in the temporary phase with an immediate addition onto the current partial denture (which is also 15 years old!).
Then restore both teeth off the single implant.
This is assuming all is well after exposure of the buried implant.
Any thoughts?
Thank you again.
peter fairbairn
7/12/2012
Hi Dr np , I would , as I said place a second with grafting to retain the bone at the site of the tooth removed and the patient would always be grateful in the long run to have two separate teeth .
Some may say the aesthetics could be an issue due to the papilla but this is generally down to skill and materials.
Regards
Peter
Dr np
7/12/2012
Thanks again,
Placing the second implant with the graft would be ideal. The patient has medium smile line and relatively low aesthetic expectations. However cost is the main barrier currently. The very large anterior open bite does help to lean towards accepting the single implant bridge? on reflection I think we will need to discuss this again with the patient again so thank you.
What do you make of the RAD? especially the coronal end of the implant?
thanks
peter fairbairn
7/16/2012
May be small amount of bon eloss but ahfter this number of years un-loaded this can happen , not to worry.As I said I think a second Implant will be a better idea to retain the bone especially between the centrals as function retains bone as per Wolffs law.
Money is always the issue which is out of our control.
Peter
Dr Campos FICOI,FADIA
7/21/2012
Recently encounter a case similar this case was 4 years since accident avulsed and reimplanted teeth root canal, internal and external resorption we had to remove 3 teeth they all had good marginal bone but huge bone defects look maybe deceiving.I'll will suggest to first extract #9 at that time evaluate #8 graft if necessary I highly recommend grafting #9 site, you eliminate a lot off guessing by using a Cat Scan. Comeback in 4 months and place implant I would use an implant with similars dimension than the one in # 8 site, just make sure your patient stay in touch. Best luck to you
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