Options for removing fully osseointegrated implant?

I have a patient who needs a removal of a fully osseointegrated implant. The coronal third of the implant fractured. This is the first time I have come across this sort of implant failure. Since the coronal part of implant is broken, there is no way to reverse it because the components cannot be detorqued. What is the best way for me to remove this implant while causing the least trauma to the patient?

6 Comments on Options for removing fully osseointegrated implant?

New comments are currently closed for this post.
CRS
5/13/2014
A film would be helpful. If the Neo OSS remover can be threaded into the implant body it may work otherwise trephine it. Trying to give advice without seeing a film to determine what the clinical situation, bone height and quality, condition of the implant and adjacent teeth( space you have to work with) is at best inadequate. But you seem to have already drawn the conclusion that it can't be detorqued so is it possible to trephine it?
Charles
5/13/2014
Seen it before, it happens. With no film available my best guess is to trephine it.
Arthur Missirlian
5/13/2014
Just took one out today. The abutment screw had broken and we tried to do a new abutment and crown without success. The Implant was placed in Mexico and the patient didn't want to go back. I used my Piezoelectric drill after studying a 3D image, to slot remove the implant with minimal trauma and bone destruction. The implant was placed to the lingual and a trephine bur would have been a disaster. I followed the removal with a bone graph and membrane. Waiting 6 months and will place a new implant in a better location.
peter Fairbairn
5/14/2014
I have taken a few ( 10 or 12 ) fractured Implants for other Dentists and 1 of mine , no problem if the coronal part has fractured off as long as there are merely a few threads internally Neobiotech will take it out very easily .....I could post cases here but I am sure they have a website you could visit . Peter
Dean Licenblat
5/14/2014
CRS is right, without imaging it is very difficult to say (CBCT woudl be ideal). I have removed implants using trephines, detorque technique & with piezo. There is generally an easy solution for every situation but anatomy and proximity to other structures & what will be left afterwards governs your decision. I personally like to trephine if I cant detorque, which ever technique will cause the least trauma to the site and the patient (from an emotional perspective) Best of Luck.
Mike Heads
5/22/2014
The Neo kit is the instrument of choice as it is quick, simple and destorys no bone at all. The trephine is the worst possible instrument you can use as it destroys so much bone. Piezo is somewhere in between. I have recently taken out two separate full integrated implants for other practitioners and they were amazed at how it took longer for the area to go numb than for me to remove the implant. In my opinion there is no compromise in this situation. If you can screw a Neo kit attachment into the implant this is what should be used every time otherwise you are open to litigation for not using the best solution for the patient

Featured Products

OsteoGen Bone Grafting Plug
Combines bone graft with a collagen plug to yield the easiest and most affordable way to clinically deliver bone graft for socket preservation.
CevOss Bovine Bone Graft
Make the switch to a better xenograft! High volume of interconnected pores promotes new bone. Substantially equivalent to BioOss and NuOss.