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Fixture Removal, ALX-IT Implant Placement, and Guided Bone Regeneration

Writer: GAO
GAO
3 days ago
2 min read

Case Summary 🔎


 Patient Information

  • Age / Sex: 62-year-old male 

  • Medical History: Currently taking antihypertensive medication and medication related to previous heart valve surgery.  

  • Clinical Diagnosis: Fracture of the implant screw at site #24, requiring removal of the fractured screw. 


Clinical Summary

A screw fracture occurred in the existing implant at site #24, compromising the structural integrity of the implant-supported restoration and necessitating removal of the existing fixture. The fractured implant was carefully removed, followed by placement of a new ALX-IT implant at the same site. After a 3-month healing period, clinical and radiographic evaluations were performed, and an intraoral scan was obtained for definitive prosthetic fabrication. Subsequently, a cementless implant-supported prosthesis was delivered, completing the prosthetic rehabilitation. 


1️⃣Pre-op


  • #24 Radiographic examination revealed a fractured screw fragment retained within the implant fixture, compromising the integrity of the implant connection.


2️⃣Surgical phase


  • The upper portion of the fixture was severely damaged, preventing proper connection of the fixture remover.

  • Remove the remaining fixture using a surgical bur and an forcep.

  • Appearance of the removed fixture.


  • Surgical Report

  •  Using VARO Guide and VARO Guide KIT

  • Drilling was performed sequentially from Ø2.2 mm to a final diameter of Ø3.5 mm. 

  • Placement of ALX-IT implants in the maxillary posterior region.

  • #14 ALX-IT Ø4.5x14, D002, 20 Ncm, cuff 3mm, IST 49

  • #15 ALX-IT Ø4.5x12, D332, 40 Ncm, cuff 3mm, IST 84


  • Comparison of Planned and Actual Implant Dimensions

  • #24: The planned implant size was Ø4.0 × 10 mm, while the actual implant placed was Ø4.5 × 14 mm.

  • #25: The planned implant size was Ø4.0 × 11.5 mm, while the actual implant placed was Ø4.5 × 12 mm.

  • The areas around the implants with insufficient residual bone were augmented using Neo-OSS B, a bovine-derived xenograft material, for guided bone regeneration (GBR). 

  • Post-operative clinical and radiographic assessment, healing abutment placement.


3️⃣Prosthetic phase


  • At the 3-month follow-up, IST values were #24–69 and #25–87.

  • As the healing process was satisfactory, the healing abutments were replaced with Encoded Scanbodies, and an intraoral scan was performed for definitive prosthetic fabrication.


  • Comparison of Immediate and 3-Month Postoperative IST Values


    - Both implants showed an increase in IST values at the 3-month follow-up.

    - Site #24 demonstrated an increase of 20 points, from 49 to 69.

    - Site #25 showed a slight increase of 3 points, from 84 to 87.

  • A screw-retained abutment was connected, followed by seating of the cementless prosthesis.

  • The cementless prosthesis was seated.

  • Post-prosthetic panoramic radiograph


 
 
 

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