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implants - internationalmagazine of oral implantology

I user report _ revision Fig. 1_Original situation following fracture, frontal view. Fig. 2_X-ray (section) of the fractured implant. Fig. 3_Fractured implant. Fig. 4_Pilot drilling to extend the depth of the implant cavity. Fig. 5_After mechanical preparation of the implant cavity the cutter is now applied. Fig. 6_After the thread is cut the implant is placed in the bony cavity. Fig. 7_Implant in situ. Fig. 8_Suture closure of the trapezial flap. _To date, implant fractures are regarded as an extreme situation, to be feared due to the severe in- juries to the jaw and the destruction of the supra- construction.Therealityisoftendifferentincasesof the effects of force (fall, blow, etc.). Fracture of the implant often remains the exception, as screws or abutments fracture instead, or the damage to the bone remains manageable and repeat treatment is possible.Thefollowingcaseshowstheprocedurefor areplacementimplantwithanIMPLAscrewimplant after fracture of a ceramic implant. Ceramic implants are susceptible to fracture due to their hard and brittle properties.1 Furthermore, surroundingepithelialgrowthintothedepthsofthe alveolushasbeenobservedforsuchimplants2 ,which can result in subsequent loss of the entire implant with no bleeding. The possibility of a replacement implant is therefore generally always an option and influencedbyboneavailabilityand,potentially,frac- tures to the alveolar process as well as inflamma- tions. These properties determine the temporal and technical approach for a replacement implant. At- tention must be paid to the primary stability of sec- ond implants, which is easily achieved through the use of implants with a larger diameter, if possible of the screw type. _Case description The first implant was placed in region 21 in the now54-year-oldpatientafterafronttoothhadbeen lostin1992.AnAl2O3implantmanufacturedbyCera- sivwasinserted.Itisinterestingtonotethatthefirst implant fractured during placement and was re- placed with an implant of the same structure. The healing process was without complications and oc- curred over a period of 6 months. After the location hadbeenopenedup,atitaniuminsertwascemented into the implant, this was then shaped and a metal ceramiccrownadded.Thediastemahadbeenleftaf- terthefirstimplant,inaccordancewiththepatient's wishes. Over the 12-year period of the implant being in place, the non-inflammatory peri-implant tissue was of note, the sulcus of which extended down ep- itheliallyovertheyears,thusreducingtheamountof activebonyinterface. Thepatientfelloffabicycleat the end of 2003 and fractured the implant in the re- Second implantation after implant fracture Authors_Dr Michael Hopp, Andreas Klar, Prof Dr Reiner Biffar, Germany 34 I implants4_2011 Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 6 Fig. 7 Fig. 8