01
Assessing the Implant Complication
Clinical and radiographic assessment identified advanced bone loss affecting more than 50% of the implant fixture length, together with chronic inflammatory soft-tissue changes. The implant position and the historical cement-retained crown were considered among the factors that may have contributed to the complication.
- High-resolution 3D CBCT bone assessment
- Clinical evaluation of peri-implant mucosal parameters
- Digital occlusal assessment and bite registration
- Digital intraoral scanning
- Microbiological assessment of peri-implant microflora
02
Site Management & Implant Removal
The affected implant was carefully removed using low-torque instrumentation. The local site was debrided and cleaned according to the planned clinical protocol before the regenerative stage was considered.
03
Guided Bone Regeneration & Site Preservation
Following implant removal, a significant bone defect remained. Guided bone regeneration was undertaken using autogenous bone particles together with a bone-substitute material selected for this case.
Platelet-rich fibrin (PRF), prepared from the patient’s own blood, was used as an adjunct to support clot stability and the early healing environment.
A lightweight, non-load-bearing provisional restoration was provided to maintain the appearance of the area while limiting pressure on the healing site.
04
Reassessment, Implant Placement & Restoration
After a monitored healing period of approximately six months, the regenerated site was reassessed clinically and with CBCT imaging. A new implant was placed in the planned restorative position. Following the required integration period, a screw-retained porcelain implant crown was fitted and the bite was reviewed.
05
Maintenance & Ongoing Review
The final crown was designed with attention to emergence profile, cleansability and functional loading. An individual three-month periodontal and restorative review interval was recommended initially, with future frequency determined by clinical findings and risk.