Segmental alveolar osteotomy by palatal approach to correct excessive angulated dental implants in anterior and posterior maxilla

Dental implants have been used for a long time to achieve better prosthetic and health conditions in the mouth. With the increase in their usage, more complications have occurred, and methods of solving these problems have been developed. One complication is insertion of the implant in the wrong direction. The aim of this case report is to describe an osteotomy technique to reposition a malpositioned dental implant. A female patient, aged 38 years, and a male patient aged 48 years, were referred complaining of the malpositioned osseointegrated implants, which had been placed in the region of the left maxillary first premolar and molar tooth, and in the region of the left maxillary lateral incisor. Due to severe buccal positioning of the implant fixtures, acceptable prosthetic treatment was not possible. Alveolar osteotomy procedure was used to reposition the implants. Satisfactory results were obtained by osteotomy for 18-month of follow up. We conclude that inadequately axially inclined implants can be successfully treated by alveolar osteotomy. The preservation of marginal gingiva permits obtaining better prosthetic results. To avoid the recession of attached gingiva, palatal approach technique may help the clinicians.