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Case Reports
. 2023 May 31;11(11):1608.
doi: 10.3390/healthcare11111608.

Advanced Techniques for Bone Restoration and Immediate Loading after Implant Failure: A Case Report

Neculai Onică  1 , Cezara Andreea Onică  2 , Elena-Raluca Baciu  3 , Roxana-Ionela Vasluianu  3 , Mihai Ciofu  4 , Mihail Balan  4 , Gabriela Luminița Gelețu  4
Affiliations
Case Reports

Advanced Techniques for Bone Restoration and Immediate Loading after Implant Failure: A Case Report

Neculai Onică et al. Healthcare (Basel). .

Abstract

The objective of this study was to report a clinical case of dental implant failure with significant bone loss that was treated using reconstructive surgical techniques. We present a 58-year-old man with a history of implant surgery and implant failure on the mandible. Data collected using cone beam computed tomography (CBCT) and intraoral scans were exported into Exoplan (exocad GmbH, Darmstadt, Germany), from which a standard tessellation file was obtained. To create a customized mandible mesh design, DentalCAD 3.0 Galway software (exocad GmbH, Darmstadt, Germany) was used. Based on guided bone regeneration, the method involved bone reconstruction and the application of a custom titanium mesh. The bone mix was obtained by combining a xenograft (Cerabone, Bottis biomaterials Gmbh, Zossen, Germany), an allograft (Max Graft, granules Bottis biomaterials Gmbh, Zossen, Germany), and an autograft. The titanium meshes were fixed to the bone using self-drilling screws and covered with a resorbable membrane. Immediately after surgery, an impression was recorded, and the next day, the patient received a milled polymethyl methacrylate interim denture. Based on our case study, the presented custom-made implant can be considered a temporary solution, during which guided bone regeneration is expected to take place.

Keywords: bone graft; dental implants; immediate dental implant loading; interim dental prosthesis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Orthopantomography image from 2014.
Figure 2
Figure 2
Pre-surgical CBCT images: (a) panoramic (green line) and cross-sectional (red line) views of bone defect after implant failure; (b) panoramic (green line) and cross-sectional (red line) views of 4.3 implant; (c) panoramic (green line) and cross-sectional (red line) views of bone defect after implant failure; (d) panoramic (green line) and cross-sectional (red line) views of bone defect after implant failure.
Figure 3
Figure 3
The surgical treatment workflow.
Figure 4
Figure 4
Virtual images of bone loss in (a) panoramic view and (b) axial view. (c) The designed custom-made titanium meshes.
Figure 5
Figure 5
Intraoperative images: (a) the residual alveolar ridge aspect; (b) flap elevation; (c) right side—custom titanium mesh application; (d) right side—fixing the custom titanium mesh with the screws; (e) right side—covering the custom titanium mesh with resorbable membrane; (f) left side—custom titanium mesh application.
Figure 6
Figure 6
Intraoral aspect of milled PMMA interim denture.
Figure 7
Figure 7
Six-month postsurgical CBCT images: (a–d) panoramic (green lines) and cross-sectional (red lines) views.
See this image and copyright information in PMC

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