Two successful clinical cases about removing an osseointegrated dental implant.

A case of osseointegrated implant removal TOOL by using EFR (Easy Fixture Removal) KIT
By: Yong Seok, Cho


Introduction:

When an implant should inevitably be removed due to clinical failure, a trephine drill was primarily and commonly used in the past. Nevertheless, this treatment method had disadvantages such as high difficulty, risk of inferior alveolar nerve damage and bone loss around the implants.

In order to avoid these disadvantages, this clinical case seeks a method to remove implants easily by using the EFR KIT which is a tool created to remove failed implants noninvasively.


Materials & Methods:

Case 1

A 41-year-old female patient had an implant inserted about 6 months back at a considerable distance from the mandibular canal. She complained, however, of a pain in the left angle and buccal region, and a paroxysmal pain when a healing abutment was touched. Although the cause was unknown, the implant had to be removed since there was no other method.

Radiography Osstem TSIII SA 4.5x7.0mm implant placed at #36.Fig 1. Osstem TSIII SA 4.5x7.0mm implant placed at #36.
Successfully osseointegrated implant after 5months 2weeks (Left). After removing healing abutment (Right).Fig 2. Successfully osseointegrated implant after 5months 2weeks (Left). After removing healing abutment (Right).
Removal process and removed implant. Fig 3. Tried to remove implant using remover body (Left). Removed implant at 200N cm (Right).

Case 2

A 30-year-old female patient visited the dental clinic for aesthetic problems and mobility of her left maxillary central incisor which was inserted seven years ago. The shape and color of the implant crown were not harmonized.

Labial soft tissue and hard tissue defects were observed. On the radiograph, fracture of Zirconia abutment, which was connected to the well osseointegrated implant, was observed. In order to remove the existing implant, the EFR KIT was used to remove the implant noninvasively.

Fracture of zirconia abutmentFig 4. On the radiograph, fracture of zirconia abutment was observed. (Left), Zirconia abutment mobility was observed when removing crown (Right).
Fig 5. Observed deficit of soft tissue and hard tissue because of placing implant which is close to labial.
Remover body tightened remover screw by counterclockwise. Removed implantFig 6. F4.0/4.5 Remover body tightened remover screw by counterclockwis. Removed implant

Results:

Case 1

The torque wrench, which can reach up to 400Ncm, was used to turn the remover body in the opposite direction (counterclockwise). After attempting the implant removal, the implant was turned at about 200Ncm.

Case 2

The torque wrench was used to remove the implant by turning the remover body counterclockwise. The implant was removed at close to 400Ncm.


Conclusions:

The EFR KIT is proven to be a very useful tool to retrieve implant. It can easily remove even completely osseointegrated implant without damaging the surrounding tissues.

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