Abstract

Table Clinic Seminar 

TITLE: Enhancing predictability of trephine-assisted explantation of fractured osseointegrated dental implants

Explantation of osseointegrated dental implants presents a challenge to the surgeons. The most non-invasive technique recommended for explantation is the Reverse Torque Technique (RTT). However, in cases presenting with fractured crest or internal channel, RTT cannot always be implemented.

Trephine assisted surgical explantation has been presented as a relatively invasive technique that may cause injury to adjoining vital structures and lead to an increased loss of peri-implant bone. Lack of real time orientation of the implants beneath the osseous crest adds to the unpredictability. Unguided use of trephines may lead to cortex perforation, vascular injuries, and consequences thereof. Considering the possibility of future implant placement, efforts should be made to minimize the bone loss around fractured dental implants during explantation. Orientation of the trephines along the length of the implant can make the explantation procedure less damaging to the bone and more predictable for the surgeons.

Use of surgical guides can best orient the trephines along the length of the implant. However, fabrication of surgical guides may not always be possible considering lack of required resources. In this presentation, various techniques are described to surgically explant osseointegrated dental implants presenting with horizontal and linear fractures. Chairside tips and techniques are also included to increase the predictability and reduce the invasiveness of trephine assisted dental implant removal. 

AUTHORS: Prof. Dr. Mahesh Verma, Dr. Smiti Bhardwaj, Dr. Harsimran Kaur