Removal of a dental implant: An unusual case report

Cunliffe, Joanne; Barclay, Craig

doi:10.4103/0974-6781.76428

Cited by 21 publications

(23 citation statements)

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“… 21 However, several publications have described the successful loosening of osseointegrated implants using high temperatures with, for example, ultra-high frequency surgical devices. 8 , 9 In these studies, the heat input was intentional but was still uncontrolled and uneven. Nevertheless, this approach, using minimal thermal necrosis for implant removal, may preserve valuable bone tissue in difficult explantations.…”

Section: Discussionmentioning

confidence: 99%

“… 5 Several case reports have shown that implants can be easily removed after an initial, uncontrolled random thermal treatment, which results in osteonecrosis of the jaw. 7 – 9 The authors’ aim, therefore, was to heat the implant in such a way that peri-implant bone necrosis was induced, with subsequent implant loosening. Data are scarce in the current literature supporting using a controlled thermo-explantation procedure or indicating the precise temperature and time interval that would produce sufficient, but minimal, osteonecrosis around the implants to remove them without incurring trauma.…”

Section: Introductionmentioning

confidence: 99%

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Implant removal using thermal necrosis—an in vitro pilot study

et al. 2020

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Objectives The purpose of this pilot porcine cadaver study was to evaluate the feasible temperature thresholds, which affect osteocyte viability and bone matrix in a preclinical setup, assessing the potential of thermal necrosis for implant removal for further in vivo investigations. Materials and methods After implant bed preparation in the upper and lower jaw, temperature effects on the bone were determined, using two tempering pistons with integrated thermocouples. To evaluate threshold temperature and time intervals leading to bone necrosis, one piston generated warm temperatures at 49 to 56 °C for 10 s and the other generated cold temperatures at 5 to 1 °C for 30 s. Effects were assessed by a semi-quantitative, histomorphometrical scoring system, scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), and transmission electron microscopy (TEM). Results The bone matrix was significantly degenerated starting at 51 °C for 10 s and 5 °C for 30 s. The osteocyte condition indicated significant bone damage beginning at cold temperatures of 2 °C. Temperature inputs starting at 53 °C led to decalcification and swollen mitochondria, which lost the structure of their inner cristae. Conclusions This study identified temperatures and durations, in both heat and cold, so that the number of samples may be kept low in further studies regarding temperature-induced bone necrosis. Levels of 51 °C for 10 s and 5 °C for 30 s have presented significant matrix degeneration. Clinical relevance Temperature thresholds, potentially leading to thermo-explantation of dental implants and other osseointegrated devices, were identified.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Implant removal using thermal necrosis—an in vitro pilot study

et al. 2020

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“…This review was also conducted in order to define a threshold bone necrosis level according to the current literature for further thermo-explantation research. If a dental implant has to be removed due to inflammation, there have been reports of the explantation being carried out with a targeted implant overheating [9,10]. In order to minimize bone damage resulting from implant explantation using drills and milling devices, there were several publications that used ultra-high frequency surgical devices for thermo-explantation [9,10].…”

Section: Introductionmentioning

confidence: 99%

“…If a dental implant has to be removed due to inflammation, there have been reports of the explantation being carried out with a targeted implant overheating [9,10]. In order to minimize bone damage resulting from implant explantation using drills and milling devices, there were several publications that used ultra-high frequency surgical devices for thermo-explantation [9,10]. Another study involved a CO 2 laser as a thermal device for implant removal [11].…”

Section: Introductionmentioning

confidence: 99%

Temperature Threshold Values of Bone Necrosis for Thermo-Explantation of Dental Implants—A Systematic Review on Preclinical In Vivo Research

et al. 2020

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Purpose: Very high or low temperatures will lead to bone damage. The objective of this review was to analyze threshold values for thermal bone necrosis. Methods: Histological animal studies evaluating thermal effects on bone necrosis were selected via electronic and hand searches in English and German language journals until 1 November 2019. The outcome measures were temperature-exposure intervals and laser settings effecting bone damage. Furthermore, investigated parameters were the bone-to-implant contact ratios (BIC) and infrabony pockets around dental implants after thermal treatment. For quality assessment of studies, the CAMARADES study quality checklist was applied. Results: A total of 455 animals in 25 animal studies were included for data extraction after screening of 45 titles from 957 selected titles of the MEDLINE (PubMed), The Cochrane Library, Embase and Web of Science search. The threshold values for bone necrosis ranged between 47 °C and 55 °C for 1 min. A threshold value for cryoinsult and laser treatment has not yet been defined. However, temperatures in the vicinity of 3.5 °C produce a histologically proven effect on the bone and in the surrounding tissue. At 50 °C for 1 min, BIC values significantly decreased and infrabony pockets increased. Bone quality had an influence on the outcome, as cancellous bone suffered higher bone damage from thermal treatment compared to cortical bone. Conclusion: No clear threshold value for bone necrosis is available according to the current literature for warm and cold stimuli. More in-depth and clinical studies are required to provide further insights in assessing the potential of thermal necrosis for implant removal.

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“…Eine Woche, nachdem diese mittels monopolarer Elektrode oder CO 2 -Laser erhitzt wurden, konnten sie problemlos mittels Re-Torque herausgedreht werden. Die postoperative Wundheilung sei ungestört verlaufen [29,30].…”

Section: Elektrochirurgieunclassified

Explantation: Indikation, Technik, Folgebehandlung

Eisenkopf¹,

Weischer²

2020

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Removal of a dental implant: An unusual case report

Cited by 21 publications

References 0 publications

Implant removal using thermal necrosis—an in vitro pilot study

Implant removal using thermal necrosis—an in vitro pilot study

Temperature Threshold Values of Bone Necrosis for Thermo-Explantation of Dental Implants—A Systematic Review on Preclinical In Vivo Research

Explantation: Indikation, Technik, Folgebehandlung

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