It is generally easier to achieve favorable primary stability in mandibular dental implant cases than in maxillary cases because the mandibular bone is harder. Nevertheless, we have experienced two cases of dental implants that were displaced into the mandibular bone. We present these two cases and describe their removal and the clinical consequences.
Case 1 : A 52-year-old female patient. The implant body was displaced into the mandibular bone during placement of the implant. The displaced implant was removed with a long guide pin from the hole made during implant surgery.
Case 2 : A 35-year-old female patient. The implant body was displaced into the mandibular bone during placement of the implant using a torque wrench. In this case, a 3-D model was prepared using computed tomographic (CT) data to simulate the surgery to remove the implant body. Buccal cortical bone was cut out and the implant body was safely removed. In both cases, no sequelae such as nerve paralysis were reported.
It is widely known that the information from panoramic and CT images is important. However, it should be emphasized that the surgeonʼs own tactile sensation during preparation of the implant bed is also important. It is recommended to decide the drilling and placement protocol based on feel during the implant surgery.
A displaced implant can be removed using either a crestal approach or a lateral approach. It is important to remove the displaced implants with appropriate surgical planning using CT data at an early timing.
"},{"@language":"ja","@value":"上顎骨と比較して下顎骨は硬く，インプラントの初期固定が得られやすいと考えられている．しかし，パノラマエックス線やCTの画像所見にて，欠損部の骨梁に顕著な透過像が認められなかったにもかかわらず，インプラント体の迷入を経験した．また，他院にて迷入したインプラント体を撤去する機会を得たため，これら2症例について報告する．
症例1は52歳の女性，低速でインプラントを埋入中に迷入が生じた．印象用のガイドピンを使用し，形成窩から引き上げてインプラント体を撤去した．症例2は35歳の女性，晩期残存した乳歯の抜去後インプラントを即時埋入し，トルクレンチで深度調整中にインプラント体が迷入した．迷入後のCT画像データから3D模型を作製後，下歯槽神経の損傷に配慮した骨削合のデザインを検討し，骨を切り出してインプラント体を撤去した．2症例ともに後遺症は認めなかった．
術前のパノラマエックス線写真やCTなどの画像所見からインプラント体の迷入を推測できる場合もある．しかし，予測が困難な場合は術中の埋入窩形成時の手指感覚から形成アプローチを勘案することが重要である．迷入したインプラント体の撤去には，埋入窩から取り出すcrestal approachと下顎骨の外側の骨を切離して取り出すlateral approachの2つの方法がある．これらはCT所見からインプラント体と神経の走向関係を把握したうえで適切に選択し，可能なかぎり早い時期にインプラント体の撤去を行うことが望ましいと考える．
"}],"abstractLicenseFlag":"disallow"}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1410301065238898056","@type":"Researcher","foaf:name":[{"@language":"ja","@value":"吉武 義泰"},{"@language":"en","@value":"YOSHITAKE Yoshihiro"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"医療法人伊東会伊東歯科口腔病院"},{"@language":"en","@value":"Itoh Dent-Maxillofacial Hospital"},{"@language":"en","@value":"Kyushu Branch"},{"@language":"ja","@value":"九州支部"},{"@language":"en","@value":"Kyushu Branch (Kyushu Implant Research Group)"},{"@language":"ja","@value":"九州支部（九州インプラント研究会）"}]},{"@id":"https://cir.nii.ac.jp/crid/1410301065238898057","@type":"Researcher","foaf:name":[{"@language":"ja","@value":"吉武 博美"},{"@language":"en","@value":"YOSHITAKE Hiromi"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Itoh Dent-Maxillofacial Hospital"},{"@language":"ja","@value":"医療法人伊東会伊東歯科口腔病院"},{"@language":"ja","@value":"九州支部"},{"@language":"en","@value":"Kyushu Branch"},{"@language":"en","@value":"Kyushu Branch (Kyushu Implant Research Group)"},{"@language":"ja","@value":"九州支部（九州インプラント研究会）"}]},{"@id":"https://cir.nii.ac.jp/crid/1420282801189987584","@type":"Researcher","personIdentifier":[{"@type":"KAKEN_RESEARCHERS","@value":"70808146"},{"@type":"NRID","@value":"1000070808146"},{"@type":"NRID","@value":"9000409465820"},{"@type":"NRID","@value":"9000412282335"}],"foaf:name":[{"@language":"en","@value":"NARIMATSU Ikue"},{"@language":"ja","@value":"成松 生枝"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University"},{"@language":"ja","@value":"九州大学大学院歯学研究院口腔機能修復学講座インプラント・義歯補綴学分野"}]},{"@id":"https://cir.nii.ac.jp/crid/1410301065238898055","@type":"Researcher","foaf:name":[{"@language":"en","@value":"HASHIGUCHI Yuma"},{"@language":"ja","@value":"橋口 有真"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Kyushu Branch"},{"@language":"ja","@value":"九州支部"}]},{"@id":"https://cir.nii.ac.jp/crid/1410301065238898053","@type":"Researcher","foaf:name":[{"@language":"en","@value":"MANABE Kanako"},{"@language":"ja","@value":"眞鍋 佳菜子"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"九州大学大学院歯学研究院口腔顎顔面病態学講座口腔顎顔面外科学分野"},{"@language":"en","@value":"Section of Oral and Maxillofacial Surgery, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University"}]},{"@id":"https://cir.nii.ac.jp/crid/1410301065238898051","@type":"Researcher","foaf:name":[{"@language":"en","@value":"SASAKI Masanori"},{"@language":"ja","@value":"佐々木 匡理"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Kyushu Branch"},{"@language":"ja","@value":"九州支部"}]},{"@id":"https://cir.nii.ac.jp/crid/1410301065238898052","@type":"Researcher","foaf:name":[{"@language":"en","@value":"KAKU Toshio"},{"@language":"ja","@value":"加来 敏男"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Kyushu Branch"},{"@language":"ja","@value":"九州支部"},{"@language":"ja","@value":"九州支部（九州インプラント研究会）"},{"@language":"en","@value":"Kyushu Branch (Kyushu Implant Research Group)"}]},{"@id":"https://cir.nii.ac.jp/crid/1410301065238898049","@type":"Researcher","foaf:name":[{"@language":"ja","@value":"松下 恭之"},{"@language":"en","@value":"MATSUSHITA Yasuyuki"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"医療法人伊東会伊東歯科口腔病院"},{"@language":"en","@value":"Itoh Dent-Maxillofacial Hospital"},{"@language":"ja","@value":"九州大学大学院歯学研究院口腔機能修復学講座インプラント・義歯補綴学分野"},{"@language":"en","@value":"Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University"}]},{"@id":"https://cir.nii.ac.jp/crid/1410301065238898054","@type":"Researcher","foaf:name":[{"@language":"ja","@value":"伊東 隆利"},{"@language":"en","@value":"ITOH Takatoshi"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Itoh Dent-Maxillofacial Hospital"},{"@language":"ja","@value":"医療法人伊東会伊東歯科口腔病院"},{"@language":"ja","@value":"九州支部"},{"@language":"en","@value":"Kyushu Branch"},{"@language":"ja","@value":"九州支部（九州インプラント研究会）"},{"@language":"en","@value":"Kyushu Branch (Kyushu Implant Research Group)"}]},{"@id":"https://cir.nii.ac.jp/crid/1410301065238898048","@type":"Researcher","foaf:name":[{"@language":"en","@value":"AYUKAWA Yasunori"},{"@language":"ja","@value":"鮎川 保則"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"九州大学大学院歯学研究院口腔機能修復学講座インプラント・義歯補綴学分野"},{"@language":"en","@value":"Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University"}]}],"publication":{"publicationIdentifier":[{"@type":"PISSN","@value":"09146695"},{"@type":"EISSN","@value":"21879117"}],"prism:publicationName":[{"@language":"en","@value":"Journal of Japanese Society of Oral Implantology"},{"@language":"ja","@value":"日本口腔インプラント学会誌"},{"@language":"en","@value":"Journal of Japanese Society of Oral Implantology"},{"@language":"ja","@value":"日口腔インプラント誌"}],"dc:publisher":[{"@language":"en","@value":"Japanese Society of Oral Implantology"},{"@language":"ja","@value":"公益社団法人 日本口腔インプラント学会"}],"prism:publicationDate":"2024-06-30","prism:volume":"37","prism:number":"2","prism:startingPage":"186","prism:endingPage":"191"},"reviewed":"true","dcterms:accessRights":"http://purl.org/coar/access_right/c_abf2","url":[{"@id":"https://search.jamas.or.jp/link/ui/2024299478"}],"availableAt":"2024-06-30","foaf:topic":[{"@id":"https://cir.nii.ac.jp/all?q=%E3%82%A4%E3%83%B3%E3%83%97%E3%83%A9%E3%83%B3%E3%83%88%E3%81%AE%E5%81%B6%E7%99%BA%E7%97%87","dc:title":"インプラントの偶発症"},{"@id":"https://cir.nii.ac.jp/all?q=%E3%82%A4%E3%83%B3%E3%83%97%E3%83%A9%E3%83%B3%E3%83%88%E8%BF%B7%E5%85%A5","dc:title":"インプラント迷入"},{"@id":"https://cir.nii.ac.jp/all?q=focal%20osteoporotic%20bone%20marrow%20defect","dc:title":"focal osteoporotic bone marrow defect"},{"@id":"https://cir.nii.ac.jp/all?q=implant%20complications","dc:title":"implant complications"},{"@id":"https://cir.nii.ac.jp/all?q=implant%20displacement","dc:title":"implant displacement"},{"@id":"https://cir.nii.ac.jp/all?q=focal%20osteoporotic%20bone%20marrow%20defect","dc:title":"focal osteoporotic bone marrow defect"}],"project":[{"@id":"https://cir.nii.ac.jp/crid/1040848250659020544","@type":"Project","projectIdentifier":[{"@type":"KAKEN","@value":"20K18639"},{"@type":"JGN","@value":"JP20K18639"},{"@type":"URI","@value":"https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-20K18639/"}],"notation":[{"@language":"ja","@value":"顎顔面補綴における皮膚貫通型インプラントの成功率向上を目指した表面処理法の検討"},{"@language":"en","@value":"Investigation of surface treatment methods to improve the success rate of transcutaneous implants in maxillofacial prosthetics"}]}],"dataSourceIdentifier":[{"@type":"JALC","@value":"oai:japanlinkcenter.org:2013297541"},{"@type":"KAKEN","@value":"PRODUCT-25549715"}]}