Surgical Repositioning of an Osseointegrated Implant Without explantation: A Novel Technique. A case report

Abstract

The success of osseointegrated implant rehabilitation depends on various factors, including achieving the best three-dimensional positioning of the implant within the residual ridge. The aim of this clinical case was to present the possibility of rehabilitating osseointegrated implants placed outside the optimal three-dimensional position with implant repositioning, avoiding complex bone reconstructions. An adult patient, without comorbidities, sought treatment to reposition the missing tooth 21. After imaging exams,  deficiency in bone thickness was observed in the region that would accommodate the implant's cervical portion. A conservative approach was offered for implant installation with ridge splitting and, if necessary, manual repositioning of the implant. After implant installation and osseointegration, it was observed that the three-dimensional positioning was not achieved, thus requiring digital repositioning of the implant. After flap elevation, directed osteotomies were performed to provide mobility to the implant,  illing the grooves with bone substitute, and suture of the flap. After 45 days, the patient was referred to finalizing the prosthetic
rehabilitation. Implant installation in an esthetic region with a partially resorbed ridge and subsequent repositioning enabled
faster anterior tooth rehabilitation, with lower biological and financial cost.