Management of a case of implant failure

1. Management of A Case of
Implant Failure
Dr. Md. Riad Mahmud BDS, MS.
Prosthodontics

2. Name: Mrs. Ishita Islam
Age : 32 years
Occupation: House wife
Address: Chittagong, Bangladesh
Chief Complaints
Dislodgement of implant prosthesis two years back.
History of Presenting complaints
According to the statement of the patient she was relatively alright
three years back. Therefore she developed toothache in the left
mandibular first molar tooth. Then she had an extraction of that tooth in
a dental office. From then she felt unpleasant to chew at the left side of
the jaw. For that reason she went to that dental surgeon for
rehabilitation of the missing tooth. She had a bridge using the adjacent
missing tooth as an abutment. Also the doctor perfumed root canal
therapy on the abutment teeth for the fixed prosthesis. But few months
later it came out while chewing bread. Then she went to the doctor
again and had an implant fixture placement surgery at two years back.
Then after around three month she had a prosthetic tooth over the
implant fixture. But unfortunately the prosthetic tooth again came out
after few days. Therefore she reported to the doctor and fixed it with
glue again. Again after few days it came out again. Then she felt
heartbroken and did not took any treatment and started chewing
betelnut. Now she came to me for correction of the failed implant.

3. Medical History: NAD
Dental History: Root canal treatment
and Crown done in the mandibular
second molar tooth three years back.
Examination:
The Implant abutment was slightly mobile.
And the implant prosthesis was attached along with a
prepared adjacent natural tooth (Second Premolar).
There was no discharge or sensitivity of that aria.
Radiological examination shows good osseointegration
between the bone and implant.

4. Correction of the occlusion by composite restoration of the faulty
preparation of adjacent second premolar tooth.
Replacement of the faulty abutment by correct abutment as the
manufacturer recommends followed by Prosthetic rehabilitation.
Preparation of the adjacent second premolar for full veneer crown.
Treatment Plan

5. Correction of the occlusion by composite restoration of the faulty preparation of adjacent second
premolar tooth.
Composite
Restoration

6. Correction of the occlusion by composite restoration of the faulty preparation of adjacent second
premolar tooth.
Restored tooth
Shape

7. Correction of the occlusion by composite restoration of the faulty preparation of adjacent second
premolar tooth.
Stable
Occlusion
Opposite
occlusion
Reestablished
Occlusion

8. Correction of the occlusion by composite restoration of the faulty
preparation of adjacent second premolar tooth.
Replacement of the faulty abutment by correct abutment
as the manufacturer recommends followed by Prosthetic
rehabilitation.
Treatment Plan

9. Replacement of the faulty abutment by correct abutment as the manufacturer recommends followed by
Prosthetic rehabilitation.
Tissue Punch
Faulty Abutment
Removal

10. Replacement of the faulty abutment by correct abutment as the manufacturer recommends followed by
Prosthetic rehabilitation.
Custom made healing cap
by the existing abutment
Healing Cap
Customization

11. Replacement of the faulty abutment by correct abutment as the manufacturer recommends followed by
Prosthetic rehabilitation.
Removal of the Custom made healing cap

12. Correct abutment placement

13. Impression Procedure and Final Prosthesis

20. Correction of the occlusion by composite restoration of the faulty
preparation of adjacent second premolar tooth.
Replacement of the faulty abutment by correct abutment as the
manufacturer recommends followed by Prosthetic rehabilitation.
Preparation of the adjacent second
premolar for full veneer crown.
Treatment Plan