Abstract
BackgroundDental implants are sometimes initially placed in a wrong position leading to esthetic damage, which is difficult to solve with prosthetics. Moreover, implants placed in the anterior sector, like ankylosed teeth, are frequently found in a wrong position over time with infraocclusion because of continuous anterior alveolar growth. Different treatments have been proposed to manage the consequences of malpositioned dental implants.Case presentationThis paper describes a surgical and orthodontic new procedure that can be used to relocate an implant in a wrong position: the Orthodontic Bone Stretching technique (OBS), which involves deep partial osteotomies combined with heavy orthodontic forces. The applied force facilitates esthetic rehabilitation with a movement towards the occlusal plane and can modify the implant axis and the gingival line alignment. This relocation is made possible thanks to a bone stretching phenomenon in the surgical area without immediate mobilization or repositioning of an alveolar segment. Three cases with the need for implant repositioning are presented here and were treated with the OBS technique.ConclusionIn the three cases presented, implant relocation was successfully performed with the OBS technique and the prosthetic crown was modified to improve esthetic results.
Highlights
Implant positioning in the anterior sector is always a challenge, as an ideal esthetic result is difficult to reach and maintain in the long term
In the three cases presented, implant relocation was successfully performed with the Orthodontic Bone Stretching technique (OBS) technique and the prosthetic crown was modified to improve esthetic results
Control CBCTs showed no problem with implant repositioning or osseointegration
Summary
Implant positioning in the anterior sector is always a challenge, as an ideal esthetic result is difficult to reach and maintain in the long term. When an implant is placed too buccally with an inadequate angulation, the prosthetic result will lead to a crown which is too long with an incorrect alignment of the gingival line. This esthetic failure may increase over time in association with gingival recession [11]. The applied force facilitates esthetic rehabilitation with a movement towards the occlusal plane and can modify the implant axis and the gingival line alignment This relocation is made possible thanks to a bone stretching phenomenon in the surgical area without immediate mobilization or repositioning of an alveolar segment. Three cases with the need for implant repositioning are presented here and were treated with the OBS technique
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