03/18/2026
Part 1: Despite saying I would post on past cases it seems the current run of emergencies are more than willing to share their experiences and it makes my point that implant complications are common and becoming more so.
I met a nice man yesterday who was referred from another office because his mandibular Hybrid was loose and it hurt. He had both arches treated in Mexico in 2020 and had not been to a dentist since. He said his symptoms began about 3 months ago.
Our initial screening panorex showed likely implant failure at site #20. The referring DDS told us that the prosthetic screws on #27 and 29 were fractured off and stuck in the abutments. As can also be seen on the panorex, the abutment for implant #22 was also broken. This one was removed and not replaced by the referring DDS. The screw remnant can be seen still within the implant.
The patient was made aware that the failed implant needed to be removed immediately and that it was very unlikely he would be able to use the hybrid, even temporarily. As seen in the images, upon removal, the broken prosthetic screws in #27 and 29 were confirmed. Implant #20 was also confirmed as mobile (failed). The blanching of the tissue in the photograph is from the anesthetic. He needed to be anesthetized due to the pain associated with the failed/infected fixture. Interestingly, there were several pieces of impression material embedded within the soft tissue around the #22 area. This was likely left from the fabrication procedures in 2020.
Now what?
I'll post how I dealt with this in a few days.
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