While dental implant fracture is rare, they can occur particularly under excessive load. This patient presented with a broken dental implant with a small segment remaining in the jaw bone. Typically, the remnant of a fractured implant can remain in place with no significant concern for infection. However, this patient wanted to have a replacement and the remaining implant fragment would block placement of a new dental implant in proper position.
For treatment, it is vital that the implant fragment is localized precisely with a cone beam CT scan (CBCT). The fragment is noted to be deep in the medial side of the jaw bone (next to tongue space) with minimal amount of bone. Displacement of the fragment into the submandibular space is a potential risk hence removal must be done very cautiously. For access, a piezo ultrasonic instrument was used to gently remove bone around the implant fragment. Then using micro instruments, the fragment was slowly mobilized and retrieved from the top. A minor site bone graft was placed to restore the defect and develop the site for the new implant which can be placed in 4 months.
Good diagnostic imaging and use of minimally invasive techniques are the key to successful management of dental implant complications which can be done safely and predictably with the right approach.