Abstract
This practice-based study presents the clinical outcomes of a minimally invasive method for retrieving failed dental implants from elderly patients. Traditional removal methods for failed dental implants include trephination and other invasive procedures. That can be a special concern for the elderly, since aging exacerbates oral surgery-related morbidity and anxiety. This retrospective cohort study gathers data from 150 patients seen in a private clinic. Their implants (n = 199) failed due to biological, mechanical, or iatrogenic causes, and were removed as part of their treatment plan. Collected data included: (1) implant location (maxilla/mandible, anterior/posterior region), (2) reasons for implant retrieval, (3) connection type, (4) removal torque, and (5) operatory procedure—flapless and using a counter-torque removal kit, whenever possible. Flapless/minimally invasive retrieval was successful for 193 implants (97%). The remaining six implants demanded trephination (open-flap). The most common reasons for implant retrieval (81%) involved biological aspects, whereas iatrogenic (12%) and biomechanical (7%) reasons were less common. The surgical technique used was not associated to connection types or removal torque. Authors conclude that a counter-torque ratchet system is a minimally invasive technique with a high success rate in retrieving implants from elderly patients. Present findings support its use as a first-line approach for implant retrieval in that population.
Highlights
Treatment with dental implants has become routine for partially and completely edentulous elderly patients [1], with increased use in recent years [2,3]. Such a frequent use invariably leads to a large number of failed implants, i.e., a high absolute number of failures despite the high success rates of contemporary implant systems, as reported for orthopedic and osteosynthesis implants [4,5]
It is noteworthy that dental implants are expected to remain in the oral cavity for a long time [6], exposing them to a series of biological and biomechanical challenges that may lead to failure
The implant removal system had a success rate of 97%, i.e., 193 implants were removed without requiring flap elevation
Summary
Treatment with dental implants has become routine for partially and completely edentulous elderly patients [1], with increased use in recent years [2,3]. Such a frequent use invariably leads to a large number of failed implants, i.e., a high absolute number of failures despite the high success rates of contemporary implant systems, as reported for orthopedic and osteosynthesis implants [4,5]. Traditional approaches for implant removal involve peri-implant osteotomy with burs or trephines, followed by extraction with forceps or an elevator [11]. Invasiveness tends to be reduced, the latter method still results in the removal of healthy bone
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