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Application of Modified Bony Lid Technique to Remove or Replace Compromised Implants: Case Series

Jung, Soong-Ryong DDS, MS, PhD*; Bashutski, Jill D. DDS, MS; Linebaugh, Michael L. DDS, MS

doi: 10.1097/ID.0b013e31828edced
Clinical Science and Techniques

Purpose: The original bony lid technique involves removing window of cortical bone using a microsaw, removing a failing implant through the window, and then replacing the bone into its original position. The purpose of this case series was to present modifications to the bony lid technique to improve outcomes.

Materials and Methods: Ten patients (9 men and 1 woman) aged between 47 and 89 years were treated during a 5-year period with modifications to the bony lid technique. Modifications to the bony lid technique included restricting the size of the bony lid, use of a long shank drill, performing guided bone regeneration, immediate implant placement, and providing rigid fixation.

Results: No complications occurred in the 10 cases presented in this case series. An immediate implant placement procedure was performed in 3 of the 10 patients treated. Fixation screws and a microplate were used to fix the bony lid in 1 patient. Allogenic bone was used in another case. Additional trephine and thin drills were used in 2 cases in the mandibular molar area.

Conclusions: Replacing failing dental implants can be successfully accomplished by removing cortical bone on the buccal aspect of the implant and then replacing this bone after the implant is removed or replaced. Using allogenic bone, fixation screws, microplates, and thin drills can help facilitate the success of this procedure.

*VA Medical Center in Detroit, Michigan, University of Michigan, School of Dentistry, Ann Arbor, MI; Adjunct Clinical Associate Professor, Department of Biologic and Material Science, School of Dentistry, University of Michigan, Ann Arbor, MI.

Clinical Assistant Professor and Director of Predoctoral Periodontics, Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI.

Associate Professor Restorative Department, School of Dentistry, University of Detroit Mercy, Detroit, MI, USA.

Reprint requests and correspondence to: Soong-Ryong Jung, DDS, MS, PhD, Department of Biologic and Materials Sciences, 1030 Dent, School of Dentistry, University of Michigan, Ann Arbor, MI 48109-1078l, Phone: +1-313-576-1129, Fax: 734-763-5503, E-mail:

© 2013 by Lippincott Williams & Wilkins, Inc.