Poor Implant Placement Causes Its Failure

The Problem: Severely Angled, Unrestorable Implant

A Poorly Placed Implant

The image below shows a critically misplaced dental implant. The green line shows the proper position for the implant and the red line shows how this implant was actually placed, severely off angle. This case demonstrates why surgical planning and execution are absolutely critical to dental implant success.

It is readily apparent that the implant for this patient was inserted without the surgeon using a surgical stent. A surgical stent is a precision guide that has a replica of the shape and position of the crown or bridge being restored. It guides the angle of the drill when preparing the site to receive the implant, ensuring proper positioning. Every dental implant should be placed with the aid of a surgical stent to provide the best restorative outcome.

Restorative Failure Despite Surgical Success

In this case, the implant was a surgical success in that it integrated well with the bone. However, it was a restorative failure because it was impossible to properly restore. The implant was severely angled toward the tooth behind it and toward the cheek. In addition, it was not placed low enough in the bone, which further complicated creating the correct abutment to hold the crown.

As a result of these placement problems, the tooth behind the implant had to be filed down in order to make room for the crown to be seated over the abutment. However, this created a gap between the crown and the tooth in front of it. The patient was constantly wedging food between the crown and that tooth, making the restoration both uncomfortable and functionally inadequate.

The abutment and crown that had been placed fell out within six months of its restoration. This failure occurred precisely because it was impossible to properly fit an anatomically correct abutment to such a poorly positioned implant. The implant could not be salvaged and had to be removed and replaced.

An Ideally Placed Implant Using a Surgical Guide

Compare the poorly placed implant above with an ideally placed implant positioned using precise surgical planning and a surgical guide. The difference in positioning is dramatic and directly affects the ability to create a restoration that functions properly and looks natural.

The Solution: Implant Replacement

As a result of the poor implant placement, the original implant could not be properly restored and had to be removed. A new dental implant was placed in the correct position, centered within the bone, and at the proper depth. A new abutment and crown were then fabricated to fit the properly positioned implant.

This case demonstrates a critical principle of prosthodontic dentistry: proper surgical planning and placement are essential foundations for successful implant restoration. Even the best technician cannot create a successful restoration on a poorly positioned implant. The investment in advanced planning technology and surgical expertise ensures that implants are positioned correctly the first time, eliminating the need for costly removals and replacements.

About Dr. Marlin

Dr. Gerald Marlin is a Washington D.C. specialist in dental implants, cosmetic dentistry, and restorative dentistry. With over 3,900 dental implants placed throughout his career, Dr. Marlin emphasizes the critical importance of precision implant placement and advanced surgical planning in achieving lasting, beautiful results. If you have a failing or poorly placed implant, contact Elite Prosthetic Dentistry for expert evaluation and treatment options.