1. Topic: Implant therapy outcomes, surgical aspects Presented at the 20th Annual Scientific Meeting of the European Association of Osseointegration 10-13 October 2012, Copenhagen, Denmark Presented at the 20th Annual Scientific Meeting of the European Association of Osseointegration 10-13 October 2012, Copenhagen, Denmark References Conclusions Background and Aim IMPLANT PLACEMENT AFTER THE REMOVAL OF OVERFILLING IN SOFT TISSUE HULYA KOCAK BERBEROGLU(1) F P AMILA BRKI(2) BANU GURKAN KOSEOGLU(1) ILKNUR OZCAN (3) (1) ISTANBUL UNIVERSITY, DEPARTMENT OF ORAL SURGERY, ISTANBUL, Turkey (2) Sarajevo University, Faculty of Dentistry, Bosnia and Herzegovina, Bosnia and Herzegovina (3) ISTANBUL UNIVERSITY, DEPARTMENT OF ORAL DIAGNOSIS, ISTANBUL, Turkey IMPLANT PLACEMENT AFTER THE REMOVAL OF OVERFILLING IN SOFT TISSUE HULYA KOCAK BERBEROGLU(1) F P AMILA BRKI(2) BANU GURKAN KOSEOGLU(1) ILKNUR OZCAN (3) (1) ISTANBUL UNIVERSITY, DEPARTMENT OF ORAL SURGERY, ISTANBUL, Turkey (2) Sarajevo University, Faculty of Dentistry, Bosnia and Herzegovina, Bosnia and Herzegovina (3) ISTANBUL UNIVERSITY, DEPARTMENT OF ORAL DIAGNOSIS, ISTANBUL, Turkey 469 Abstract Results Methods and Materials Treatment of missing teeth includes a several restorative options, among which none has been proven to be effective and durable as dental implants. The basis of success of prosthetic rehabilitation with dental implants is in osseointegration, which is under influence of systemic and local factors such as bone quality and quantity, presence or absence of soft tissues, pathological lesions or foreign bodies including overfilled endodontic materials near the implant surfaces. Overfiling of a root canal is a complication characterized by extrusion of endodontic fillings beyond the radiographic apex of the tooth. Root canal filling materials due a site of extrusion, might act as a foreign body causing chemical or mechanical irritations of periapical tissues, ranging from mild inflammatory and allergic reactions to neurotoxic damages The aim of this work is to describe a case of prosthetic rehabilitation with dental implants in patient which quantity of alveolar bone was reduced by osteotomy during extraction of the root remnant and „curretage of fillinig material“, located in the fibers of the raised mucoperiostal flap. Extruded endodontic material found to have perforated the cortical bone of maxilla and passed through the mucoperiosteum to the muscle fibers, is a result of the specificity of bone resorption process in the maxilla. Elimination of foreign bodies including overfilled endodontic materials or unfunctional root remnants before dental implant placements, is necessary to be performed, thus to limit the influence of these local factors on infection development and implant therapy failure. A 53 year-old male patient referred with complaints of 6 months persisting pain and mild swelling under the porcelan bridge of the left maxilla. Clinical and radiographic examinations revealed partially edentulous upper and lower jaws, prosthetically rehabilitated with porcelain crowns and bridges. A foreign body suspected to be an overfilled endodontic material in the region of upper left second premolar and root remnant of the first premolar were noted too (Figure 1). Figure 1. Figure 2. Under local anesthesia extractions of the root remnant and second premolar, with the curretage of endodontic material were performed. However, control panoramic radiograph showed persistence of the „curretaged material“, finally excised from the soft tissue of the mucoperiostal flap. The bone defect was filled with synthetic bone graft and covered with colagene membrane. At the same seance from the right side of maxila 3 XiVE® implants were placed in the former elements of upper 14,15 and 16 teeth (Figure 2.). Six months later, after the control panoramic radiograph revealed good osseointegration of the graft material (Figure 3.), the left side of maxilla was also prosthetically rehabilitated with XiVE® implants of former elements of 24,25 and 26 (Figure 4). Four months later prosthetic rehabilitation with new porcelain bridges was completed. The patient is under routine follow up for 16 months without any complaints or complications (Figure 5.). Figure 3. Figure 5. Prosthetic rehabilitation with dental implants is the best solution for replacement of missing teeth in the cases of good bone preservation. The basis of success is in osseointegration, which is under influence of systemic and local factors. The aim of this work is to describe a case of prosthetic rehabilitation with dental implants in patient which quantity of alveolar bone was reduced by osteotomy during extraction of the root remnant and „curretage of fillinig material“, located in the fibers of the raised mucoperiostal flap. After the successful excision of the overfilled material and bone augmentation with synthetic bone graft, the prosthetic rehabilitation was obtained by placement of six dental implants. The patient is under routine follow up for 16 months without any complaints or complications. 1.Silva JA, de Alencar AH, da Rocha SS, Lopes LG, Estrela C. Three- dimensional image contribution for evaluation of operative procedural errors in endodontic therapy and dental implants. Braz Dent J. 2012;23(2):127-34. 2. Doyle SL, Hodges JS, Pesun IJ, Baisden MK, Bowles WR. Factors affecting outcomes for single-tooth implants and endodontic restorations. J Endod. 2007 Apr;33(4):399-402. 3. Brkić A, Gürkan-Köseoğlu B, Olgac V. Surgical approach to iatrogenic complications of endodontic therapy: a report of 2 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009 May;107(5):e50-3. 4. Elemam RF, Pretty I. Comparison of the success rate of endodontic treatment and implant treatment. ISRN Dent. 2011;2011:640509. Epub 2011 Jun 15. 5.Derhalli M, Mounce RE. Clinical decision making regarding endodontics versus implants. Compend Contin Educ Dent. 2011 May;32(4):24-6, 28-30, 32-5; quiz 36. Figure 4.