Akademik Veri Yönetim Sistemi
48th European Prosthodontic Association (EPA) and 27th Turkish Prosthodontics and Implantology Association (TPID) Annual Congress, Nevşehir, Türkiye, 11 - 13 Eylül 2025, ss.200-201, (Özet Bildiri)
Impacted maxillary canines are frequently encountered and may lead to significant aesthetic, functional, and periodontal complications in the anterior maxilla. In such cases, the surgical approach must be carefully planned, taking into account the position of the impacted tooth and its relationship to surrounding anatomical structures. Coronectomy is a conservative surgical technique aimed at preventing trauma to adjacent tissues during the removal of impacted teeth. Additionally, in the anterior region—where aesthetic demands are high—adherence to biomechanical principles in both surgical and prosthetic planning is critical for treatment success. This case report presents a patient who underwent coronectomy of an impacted maxillary canine followed by implant placement, which subsequently failed due to biomechanical factors.
A 55-year-old male patient with no systemic disease presented with an impacted maxillary right canine (tooth 13), radiographically shown to be in close proximity to the roots of teeth 14 and 15. A coronectomy was performed to avoid injury to the adjacent roots, and the defect was filled with Gen-Os bone graft. Seven months later, due to inadequate bone volume, a 4 mm diameter, 8.5 mm length implant (OSSTEM TSIII SA Fixture ) was placed, positioned 6 mm apical to the cemento-enamel junction of the adjacent teeth. The prosthetic restoration featured a 12 mm crown height, which resulted in compromised biomechanical load distribution. The patient reported mobility in the implant one year after placement but did not seek clinical evaluation until five years later. Clinical examination revealed suppuration, horizontal mobility, and absence of attached gingiva. The implant was surgically removed under general anesthesia, and an iliac bone graft was placed. A lateral pedicle flap was used to achieve soft tissue closure. Following bone healing, vestibuloplasty was planned. In the interim, a temporary prosthesis fabricated from polyamide material was delivered to meet the patient’s aesthetic needs.
This case underscores the importance of not only evaluating bone quantity but also ensuring biomechanical compatibility during implant planning. The combination of excessive crown height, insufficient soft tissue, and suboptimal implant positioning contributed to implant failure. Successful long-term outcomes rely on comprehensive surgical and prosthetic planning in accordance with biomechanical principles.