Case Study: Management of Dental Implants with Suboptimal Angulation

Case Study: Management of Dental Implants with Suboptimal Angulation

Referral case: Implant Complication

by Dr Manuel Man

Introduction:

A 28-year-old male patient was referred presenting with a hardware complication involving dental implants with suboptimal angulation (UR1, UL1). The patient expressed dissatisfaction with a chipped implant crown (UL1) and the aesthetic appearance of his upper front teeth, particularly their angulation. The complexity of the case was further amplified by the implants’ angulated placement. Upon examination, a fracture on the incisal corner of the upper left second tooth (UL2) and signs of tooth wear were also identified.

Diagnosis:

The patient’s occlusal problem was pinpointed as the primary cause for the chipping of his tooth and damage to the implant crown, highlighted by the lack of shared anterior guidance. The unsightly aesthetic outcome is exacerbated by the angulated placement of the implants.

Treatment Strategy:

After being informed about the impact of his occlusal problem on the longevity of the teeth and implant crowns, the patient agreed to a treatment plan. This approach involved replacing two implant crowns and applying
composite bonding to the remaining front teeth. The aim was not only to improve the alignment of the teeth but also to provide an evenly shared anterior guidance during function, taking into account the challenge posed by the implant angulation.

Results:

The applied treatment plan successfully improved the aesthetic outcome and resolved the occlusal issues. The new implant crowns, combined with the composite bonding on the other front teeth, resulted in better teeth alignment and provided a shared anterior guidance, despite the initial complexities due to the angled implants.

Conclusion and Learning Points:

This case study underlines the importance of comprehensive planning when dealing with complex restorative cases, especially when they involve angulated implant placement. It is crucial to simultaneously address both functional issues like occlusal problems and aesthetic concerns. Proper planning and execution are key to achieving successful outcomes in such cases.

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