Dr P. S. Prabu MDS Malabar Dental College & Research Centre

1. EXPLANTATION - BEYOND
THE HORIZON
Dr P. S. Prabu MDS
Malabar Dental College & Research
Centre

4. IMPLANT FAILURE ????
• It is defined as total failure of the implant to
fulfill its purpose ( functional ,esthetic or
phonetic) because of mechanical or biological
reasons.
ASKARY et al id 1999 vol8 n02 173-178

6. • EXPLANTATION is a procedure to remove dental implants
• The key is to minimize the risk of postoperative complication,
including excessive removal of bone and soft tissue, so as not to
exclude future implant therapy.

7. DIFFERENT EXPLANTATION
TECHNIQUES
• Scalpel–forceps technique (SF)
• Bur–forceps technique (BF)
• Neo bur–elevator–forceps technique (hBEF)
• Trephine drill technique (TD)
• High torque wrench technique (HTW)
• Electro-surgery
• Laser assisted explantation

8. THE SCALPEL–FORCEPS TECHNIQUE (SF)

9. BUR–FORCEPS TECHNIQUE
(BF)

11. Neo bur–elevator–forceps technique
(hBEF)

12. Trephine Drill technique (TD)

14. HIGH TORQUE WRENCH
TECHNIQUE ( HTW)
Specially designed instruments or kits
• Biomed 3i implant removal kit
• Neo Fixture Remover Kit (Neobiotech),
• BTI Implant Extraction System (Biotechnology Institute S.L.)
• Implant Retrieval Tool (Nobel Biocare).
In essence, two types of instrument are used,
• Screw-type to engage the implant
• High-torque dynamometric ratchet to unwind the implant.

15. Tighten up to 35~50Ncm.
Endurance of removing torque up to 400Ncm.

16. Ratchet Arm Torque Indicator Body Spring Loaded Indicator Pin

18. The selection of the explantation technique depends on :

19. ELECTROSURGERY
Implant in incorrect position Screw head showing angulation of implant Tip of electro-surgical unit placed into head of implant
Implant removal with torque wrench Fresh bleeding socket Bio-Gide over the extraction socket

20. LASER EXPLANTATION
deep probing defects and macroscopic damage to the implant hex

21. The 14 mm optical laser tip inserted adjacent to the implant.
The postoperative appearance of the surgical
site after implant removal.
The surgical site after irradiation with the
Er,Cr:YSGG laser to the correct working length
of 10 mm.

22. WHICH BEEN THE BEST???
• Explantation techniques appeared to be successful for the removal of
failing implants.
• The BF/ηBEF and SF techniques demonstrated 100% success.
• The ηBEF technique enabled safe insertion of a new implant in the same
explantation site.
• The HTW technique appeared to be the most elegant technique with the
highest predictability for insertion of another implant.
International Journal of Oral and Maxillofacial Surgery Volume 45, Issue 5, May 2016, Pages 641-648