Unconventional Implant Placement Part III: Implant Placement Encroaching upon Residual Roots - A Report of Six Cases

Clin Implant Dent Relat Res. 2015 Oct:17 Suppl 2:e396-405. doi: 10.1111/cid.12256. Epub 2014 Jul 17.

Abstract

Background: When a residual root is found in the way of a planned implant placement, invasive surgery is usually performed in order to remove it. Consequently, implant therapy is rendered more complex and lengthy.

Purpose: We present 6 cases treated according to an unconventional protocol in which invasive surgery was avoided by allowing the implants to encroach upon the residual roots in order to permit a prosthetically driven surgery.

Materials and methods: Six patients were treated with 7 implants placed through a residual root (4 in the mandible and 3 in the maxilla). The residual roots had to be clinically and radiographically asymptomatic and covered by bone or healthy gingiva. The radiographic follow-up ranged from 20 months to 9 years.

Results: Healing was uneventful. Implants were clinically stable, and radiographic examination did not show any unusual feature at the root-implant interface.

Conclusion: Several types of new implant-tissue interfaces were created in addition to the classical implant-bone interface, but this did not seem to jeopardize implant integration. Reports of more cases with a longer follow-up are needed before this protocol can be endorsed for routine application. Nonetheless, if confirmed as acceptable, this protocol might open intriguing possibilities; it might also lead to revision of one of the leading concepts in dental implantology.

Keywords: implant-bone interface; implant-cement interface; implant-dentin interface; mineral integration; osseointegration; paradigm shift; residual roots.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Dental Implantation, Endosseous / methods*
  • Dental Implants
  • Female
  • Humans
  • Male
  • Mandible
  • Maxilla
  • Middle Aged
  • Radiography, Dental
  • Tooth Extraction / adverse effects
  • Tooth Root / diagnostic imaging
  • Tooth Root / surgery*

Substances

  • Dental Implants