Malpositioned osseointegrated implants relocated with segmental osteotomies: a retrospective analysis of a multicenter case series with a 1- to 15-year follow-up

Purpose: This multicenter case series evaluates retrospectively the clinical outcomes of malpositioned implants surgically relocated in a more convenient position by segmental osteotomies.

Materials and methods: Authors who published, on indexed journals or books, works about malpositioned implant correction by segmental osteotomies were contacted. Five centers, out of 11 selected, accepted to participate in this study. The dental records of patients who underwent implant relocation procedures were reviewed. Implant survival rates were analyzed and a blinded assessor examined clinical photos and periapical radiographs to evaluate esthetic outcome (pink esthetic score [PES]) and changes of marginal bone level over time. Patients were requested to fill a verbal rating scale form about discomfort, compliance, and satisfaction related to the procedure.

Results: Fifteen malpositioned implants relocated by segmental osteotomies were followed for a period ranging from 1 to 15 years (mean 6.0 ± 3.9 years). The overall implant survival rate from baseline to the last follow-up visit was 100%. The mean marginal bone loss was 0.36 mm at the 12-month follow-up visit and no relevant further changes were observed at the following examinations. Significant esthetic improvement was recorded at 1-year examination with PES evaluation (p < .0001). Patients' feedback described this procedure as not excessively invasive and uncomfortable, reporting a high final satisfaction rate.

Conclusions: The present study suggests that implant relocation with segmental osteotomies could be an effective alternative method to correct the position of unrestorable malpositioned implants in a single-stage surgery.