Removal of fractured implants and replacement with new ones

In August 2008, a 56-year-old nonsmoking male patient was referred to the clinic (Baskent University, Faculty of Dentistry, Oral and Maxillofacial Surgery Department, Ankara, Turkey). The patient complained of pain, bleeding at the gingival margin, and loosening of a 4-unit implant supported prosthesis in the mandibular left premolar-molar region. The fixed prosthesis was mobile; however, the implant mobility was not present. The panoramic radiograph revealed no evidence of fracture or marginal bone loss around the implant. An implant-supported fixed partial denture (FPD) with 2 pontics was performed. Two years after the FPD was completed, the patient complained about the mobilization of this unit and went to their own clinician. The fixed denture was removed and the gold screws of the crowns were retightened. The treatment included complete removal of the fractured implants, bone grafting, and placement of 2 new implants with larger diameters. This treatment was chosen because of the chronic screw loosening and bone resorption on the buccal part of the implants.