Flowered dental implant
Do you have a flowered dental implant?
Flowered dental implant, huh? Well that sucks. Time to remove it as that is a big dental implant problem.
What is a flowered dental implant?
A dental implant that has flowered is one in which the top portion broke and opened up more the same way a flower opens up. Some brands have this happen more than others if the metal around the coronal (top) portion is thinner. Today more implants are taking advantage of platform switching which makes flowering of the head much less likely.
How do we treat a flowered dental implant?
There is no treatment. The implant is useless at this point and we need to remove it. The tricky part is that since the head is broken nothing will attach to it so you can not reverse torque it out, well not easily. There is a special tool that will allow you to sometimes do this still. It basically taps into the implant and locks in.
Another option for removal of a dental implant is with a trephine drill. This can be pretty invasive depending on how big the implant is.
Finally, you can just drill out a portion of the dental implant. This is the least common method of dealing with a flowered dental implant but does have it’s place. For example in the case seen in Sahl’s JOI 2018 article, there was a good reason not to try to mess with the apical portion of the implant.
What are the signs that an implant has fractured?
A dental implant that has flowered can often be seen visually after awhile. However, the restoration will get loose, well actually the screw will get loose, before there is visible evidence. A hairline crack will allow for a loose screw but the crack may not be seen. This can result in a screw that continues to loosen over and over again. Small cupping bone loss will be seen on the x-ray after some time.
Why do dental implants fracture?
Basically it is too much stress or force for the metal implant. Allowing a loose crown and screw to rock on the implant for long periods of time will cause something to break, usually the screw but it could be the implant. Any brand that has a thin metal coronal position will be more prone to fracture. Two examples are Zimmer 6.0 with a 5.7 platform and Biohorizons 5.8 with a 5.7 platform, this last one is seen above. Individuals that are heavy clenchers or grinders are more likely to be supplying the kind of force necessary to flower a dental implant.
Impact titanium Grade has on flowering.
Grade 5 is stronger and will fracture less often than Grade 4.
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