Retrievability of Failing Zircon Dental Implant: A Case Report

Abstract

Background: Zirconia (Zr) dental implants have emerged as an alternative to titanium implants in implant dentistry. However, their removal can present considerable challenges because of the material's brittleness and susceptibility to fracture. This case report describes the surgical challenges encountered during the removal of a malpositioned zirconia implant and the subsequent management of the resulting bone defect. Case Presentation: This case report describes a female patient who received a Zr implant in the upper first premolar region. However, the implant was malpositioned, causing pain and pressure on the adjacent mesial tooth. A full-thickness flap was raised, and the bone was exposed. Attempts to remove the Zr implant using various techniques and tools were complicated by the implant's brittleness, which led to fracture and difficulties during removal. Ultimately, surgical removal required extensive bone removal, resulting in a significant bone defect. Fortunately, examination of the adjacent root revealed no damage due to implant misalignment. A guided bone regeneration procedure was performed to rebuild the bone defect, using platelet-rich fibrin to enhance soft tissue healing. After four months of bone graft healing, two titanium implants were placed with satisfactory primary stability. Discussion: Removal of the malpositioned zirconia implant proved challenging because of its brittleness and tendency to fracture, ultimately requiring extensive bone removal and creating a significant bone defect. Nevertheless, the adjacent tooth root remained intact. Following guided bone regeneration and a four-month healing period, the site permitted the placement of two titanium implants with satisfactory primary stability. Conclusion: This case highlights the technical challenges associated with removing malpositioned zirconia dental implants and the potential for implant fracture and substantial bone loss during retrieval. Retrieval of Zr dental implants may require specialized tools designed to accommodate the material's unique characteristics. Further research is needed to develop more effective strategies for managing Zr implant failures.