PMC10065860_01
CBCT after implant dislocation. (a) Reformatted panoramic image. (b) Axial reconstruction. (c) Sagittal reconstruction. (d) 3D reconstruction of the mandible (lingual view). All images show that the implant is located below the level of the mandibular canal.
CRID2023-6663874.001.jpg
PMC10065860_01_CRID2023-6663874.001.jpg
fig1
The CBCT examination revealed the presence of one vertically positioned implant in the area of tooth #46 and one horizontally displaced implant below the level of the mandibular canal (Figure 1).
(a and b) Stages of operation to remove the dislocated implant. (c) The removed implants.
CRID2023-6663874.002.jpg
PMC10065860_01_CRID2023-6663874.002.jpg
fig2
Using an ultrasonic surgical device (Piezosurgery touch, Mectron S.p.A., Loreto, Italy), a horizontal cortical bone window was formed using OT6 and OT7 tips (Mectron S.p.A.), in the lower part of the body of the mandible, parallel to the dislocated implant (Figure 2(a)). The implant was identified, carefully released from the surrounding soft trabecular bone, and removed without damaging the integrity of the mandibular canal (Figures 2(b) and 2(c)).
CBCT after implant removal. (a) Sagittal reconstruction. (b) Reformatted panoramic image. (c) Axial image. (d) 3D reconstruction.
CRID2023-6663874.003.jpg
PMC10065860_01_CRID2023-6663874.003.jpg
fig3
A postoperative CBCT examination (Figure 3) was performed and confirmed that the right posterior side of the mandible was without the implants.
CBCT data after implant displacement. (a) (left) Vertical cuts. (b) (right) Axial reslice. Measurements of the implant bed at the site of displaced implant. The data show that the osteotomy dimensions are significantly larger than the diameter of the implant used. The lower border could not be determined.
CRID2023-6663874.004.jpg
PMC10065860_01_CRID2023-6663874.004.jpg
fig4
Overpreparation was detected at the implant site, both in vertical and horizontal dimensions, including the cortical bone plate at the top of alveolar ridge (Figure 4).
Distribution of relative bone density considering height of the alveolar ridge, next to the osteotomy area. The sharp decrease in bone density from the 13th to 15th mm corresponds to the position of the mandibular canal.
CRID2023-6663874.005.jpg
PMC10065860_01_CRID2023-6663874.005.jpg
fig5
The cross section results of the measurements are shown in Figure 5.