Approaching Dental Implants from the right angle: recognizing, preventing and treating misaligned esthetic implants.

This lecture provides information about the ways to prevent misaligned implants (including the use of analogue and digital guided surgery) and how to identify and treat the cases that can be salvaged. The circumstances under which the removal of an implant is more appropriate is discussed.

Misaligned implants in the aesthetic zone are not only frustrating to both clinician and patient but also can prove costly in both time and money. With modern technology and full digital flow, misalignment can be avoided. Technology, however, comes at a high cost, making it prohibitive in some cases. Many previously placed implants also present for new restorations with expectations of more favourable aesthetic results. When a misaligned implant presents for restoration, options should be carefully weighed before choosing a treatment option.

The best treatment, of course, is to avoid misalignment through proper planning, pre-surgical preparation and the use of a digital flow. When misalignment occurred, minor deviations can often be corrected via prosthodontic and/or surgical means. Sometimes, however, such correction is not possible, and the only option is a surgical redo, which does not always yield a satisfactory result. According to guidelines, the decision to remove an implant should be made as soon as possible to avoid unnecessary tissue loss (which makes reconstruction more difficult) and plans for replacing the implant should be kept in mind at this initial surgery.

LEARNINGS:

This lecture provides information about the ways to prevent misaligned implants (including the use of analogue and digital guided surgery) and how to identify and treat the cases that can be salvaged. The circumstances under which the removal of an implant is more appropriate is discussed.

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