If you do enough implants you will deal with failures. Luckily most are catastrophic, they just fall out of the patient’s head. But sometimes they just don’t want to come out easy. Here is a case where I got to do something I have been dying to do! Remove an implant via electrosurge! So think about it, how are you usually supposed to remove an implant? With a trephine! But that being said you destroy so much bone. Also, why are you not supposed to do electro cautery around implants? Well it heats the implant and necroses the bone. So I heard of studies where researchers used an elctrosurge for 20 seconds on a failing implant, waited a week, then went back and removed it with little bone loss. So I gave it a go! Here you can see that the implant in the #8 position is failing. Funny, look at the X-ray vs the CBCT. Thats why its so valuable. I had done a ridge split, which now I never do and its for this reason, a lot resorb and its tough to stabilize the implant.
It took forever and a day to get it out, but when I did I put a hex tool into the implant and it would not budge. So i went down the hall and borrowed the doc’s electrosurge and had at it for 20. Talk about a firework show! The patient then returned in about a week for the implant to be removed.
Sorry for the gore but this is just too cool! The implant practically jumped out after a week. Some soft tissue in the socket but not as much as some failures. Scraped it out, grafted with DFDBA and moved tissue from the palate to the buccal. Gave it a good 4 months to heal.
Notice the nice firm keratinized tissue on the #8 position. Opted for a straight PFM Bridge on custom abutments.
Here is the final. Is it perfect? No, but we are lucky to have a low smile line and its a lot more cleanable than my first one. You can’t win them all!