Abstract
Posterior mandible region is considered a highly predicable place for primary stability during dental implant placement. Although, this region can present a significant decrease in bone density, which can lead to implant dislocation during insertion. The present case reports an unusual dislocation of dental implant in a 59 old healthy patient's mandible and a secure solution for this kind of complication. During the drilling, bone quality type IV was observed. In sequence, implant was abruptly inserted in the perforation site and dropped into the bone marrow. Panoramic radiograph showed the implant inside bone marrow, close to mandibular base. The implant was removed through the surgical site. The screw of the implant prosthesis transfer was used to reach the displaced implant. A second implant with the same dimensions as the first one, differing by the external hexagon, was inserted into the same implant site. Therefore, the authors strongly recommend the use of the presented technique prior to osteotomy on mandibular body, reserving the second in the impossibility of reaching the internal connection of the displaced implant.
Highlights
Dental implant surgery has become a highly predictable procedure; risks are still associated with the surgical or restorative therapy phase
Intraoperative complications and accidents related to surgery have included hemorrhage, nerve damage, mandibular fractures, and damage to adjacent teeth, lack of primary stability, and displacement or migration of implants (Camargo & van Sickels, 2015; Chrcanovic & Custódio, 2009; Lamas Pelayo et al, 2008; Real-Osuna et al, 2012)
Very few cases have been previously published of displacement of dental implants into the medullary space of the mandible during implant surgery (Bayram & Alaaddinoglu, 2011; Doh et al, 2011; Kim et al, 2017; Oh et al, 2016; Pistilli et al, 2018).When it occurs, it can be associated with osteopenic bone with a low quality of bone marrow (Holahan et al, 2008; Lee et al, 2013)
Summary
Dental implant surgery has become a highly predictable procedure; risks are still associated with the surgical or restorative therapy phase. Very few cases have been previously published of displacement of dental implants into the medullary space of the mandible during implant surgery (Bayram & Alaaddinoglu, 2011; Doh et al, 2011; Kim et al, 2017; Oh et al, 2016; Pistilli et al, 2018).When it occurs, it can be associated with osteopenic bone with a low quality of bone marrow (Holahan et al, 2008; Lee et al, 2013). Further computed tomography (CT) exams should be performed(Marar et al, 2020) Once this kind of manifestation is present, the primal stability is reached anchoring the implant exclusively on the cortical bone (Sugiura et al, 2019). The present case reports an unusual dislocation of dental implant in a 59 old healthy patient's mandible and a secure solution for this kind of complication
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