This case report discusses the approach and considerations involved in retrieving a fractured implant abutment screw. A 69-year-old male patient presented with a dislodged implant prosthesis caused by a fractured abutment screw. The fracture occurred at the most apical portion of the screw, specifically in the threaded region, making its retrieval particularly challenging. The screw was successfully removed using a commercially available retrieval kit. The effectiveness of the kit was attributed to a guide that allowed the retrieval instrument to align precisely with the long axis of the implant. Without such a guide, a risk of damaging the internal threads of the implant fixture exists, potentially leading to the need for implant removal. Therefore, using a retrieval kit with a guide or fabricating a custom-made guide is crucial for preventing implant damage and ensuring proper alignment during the procedure.

This case report discusses the approach and considerations involved in retrieving a fractured implant abutment screw. A 69-year-old male patient presented with a dislodged implant prosthesis caused by a fractured abutment screw. The fracture occurred at the most apical portion of the screw, specifically in the threaded region, making its retrieval particularly challenging. The screw was successfully removed using a commercially available retrieval kit. The effectiveness of the kit was attributed to a guide that allowed the retrieval instrument to align precisely with the long axis of the implant. Without such a guide, a risk of damaging the internal threads of the implant fixture exists, potentially leading to the need for implant removal. Therefore, using a retrieval kit with a guide or fabricating a custom-made guide is crucial for preventing implant damage and ensuring proper alignment during the procedure.

This case report discusses the approach and considerations involved in retrieving a fractured implant abutment screw. A 69-year-old male patient presented with a dislodged implant prosthesis caused by a fractured abutment screw. The fracture occurred at the most apical portion of the screw, specifically in the threaded region, making its retrieval particularly challenging. The screw was successfully removed using a commercially available retrieval kit. The effectiveness of the kit was attributed to a guide that allowed the retrieval instrument to align precisely with the long axis of the implant. Without such a guide, a risk of damaging the internal threads of the implant fixture exists, potentially leading to the need for implant removal. Therefore, using a retrieval kit with a guide or fabricating a custom-made guide is crucial for preventing implant damage and ensuring proper alignment during the procedure.

Patients with disabilities have difficulties tolerating in-office dental treatment due to limitations relating to cooperation and/or physical problems. Therefore, they often require general anesthesia or sedation to facilitate safe treatment. When deciding on dental treatment under general anesthesia, the plan should be carefully determined because compared to general patients, patients with disabilities are more likely to experience anesthetic complications because of their underlying medical conditions and potential drug interactions. Clinicians prefer simpler and more aggressive dental treatment procedures, such as extraction, since patients with impairment have difficulty maintaining oral hygiene, resulting in a high incidence of recurrent caries or restorative failures. This study aimed to review the available literature and discuss what dentists and anesthesiologists should consider when providing dental treatment to patients with severe disability under general anesthesia.

Foreign body aspiration in dental clinics is the most common cause of respiratory emergencies. There are no reports on foreign body aspiration during dental treatment under stable general anesthesia because the patient neither has voluntary movements nor reflex actions. This is a case report on the fall of a prosthesis in the larynx, which occurs rarely under general anesthesia. During the try-in procedure, the prosthesis slid from the surgeon's hand and entered the retromylohyoid space, and while searching for it, it passed down the larynx to the endotracheal tube balloon, leading to a dangerous situation. The prosthesis was promptly removed using video-assisted laryngoscope and forceps, and the patient was discharged without any complications.
Anesthesia, General ; Dental Clinics ; Emergencies ; Foreign Bodies ; Hand ; Humans ; Laryngoscopes ; Larynx ; Prostheses and Implants ; Reflex ; Surgical Instruments

Paresthesia is an altered sensation of the skin, manifesting as numbness, partial loss of local sensitivity, burning, or tingling. The inferior alveolar nerve (IAN) is the third branch of the trigeminal nerve and is very important in dental treatment. IAN paresthesia may occur after various dental procedures such as simple anesthetic injections, surgical procedures, and endodontic treatment, and is reported to range from 0.35% to 8.4%. The altered sensation usually follows immediately after the procedure, and reports of late onset of nerve involvement are rare. This report presents a rare case of delayed paresthesia after dental surgery and discusses the pathophysiology of IAN delayed paresthesia.
Burns ; Hypesthesia ; Mandibular Nerve ; Paresthesia ; Sensation ; Skin ; Trigeminal Nerve

PURPOSE: On maxillofacial tumor patients, oral implant placement prior to postoperative radiotherapy can shorten the period of prosthetic reconstruction. There is still lack of research on effects of post-implant radiotherapy such as healing process or loading time, which is important for prosthodontic treatment planning. Therefore, this study evaluated the effects of post-implant local irradiation on the osseointegration of implants during different healing stages. MATERIALS AND METHODS: Custom-made implants were placed bilaterally on maxillary posterior edentulous area 4 weeks after extraction of the maxillary first molars in Forty-eight Sprague-Dawley rats. Experimental group (exp.) received radiation after implant surgery and the other group (control) didn't. Each group was divided into three sub-groups according to the healing time (2, 4, and 8 week) from implant placement. The exp. group 1, 2 received 15-Gy radiation 1 day after implant placement (immediate irradiation). The exp. group 3 received 15-Gy radiation 4 weeks after implant placement (delayed irradiation). RESULTS: The bone mineral density (BMD) was significantly lower in the immediate irradiation groups. BMD was similar in the delayed irradiation group and the control group. The irradiated groups exhibited a lower bone-to-implant contact ratio, although the difference was not statistically significant. The irradiated groups also exhibited a significantly lower bone volume and higher empty lacuna count than the control groups. No implant failure due to local irradiation was found in this study. CONCLUSION: Within the limits of this study, the timing of local irradiation critically influences the bone healing mechanism, which is related to loading time of prostheses.
Bone Density ; Head and Neck Neoplasms ; Humans ; Molar ; Osseointegration ; Pilot Projects* ; Prostheses and Implants ; Radiotherapy ; Rats, Sprague-Dawley

Issues related to the control of seizures and bleeding, as well as behavioral management due to mental retardation, render dental treatment less accessible or impossible for patients with Sturge-Weber syndrome (SWS). A 41-year-old man with SWS visited a dental clinic for rehabilitation of missing dentition. A bilateral port-wine facial nevus and intraoral hemangiomatous swollen lesion of the left maxillary and mandibular gingivae, mucosa, and lips were noted. The patient exhibited extreme anxiety immediately after injection of a local anesthetic and required various dental treatments to be performed over multiple visits. Therefore, full-mouth rehabilitation over two visits with general anesthesia and two visits with target-controlled intravenous infusion of a sedative anesthesia were planned. Despite concerns regarding seizure control, bleeding control, and airway management, no specific complications occurred during the treatments, and the patient was satisfied with the results.
Adult ; Airway Management ; Anesthesia* ; Anesthesia, General ; Anxiety ; Dental Clinics ; Dentition ; Gingiva ; Hemorrhage ; Humans ; Infusions, Intravenous ; Intellectual Disability ; Lip ; Mouth Rehabilitation* ; Mouth* ; Mucous Membrane ; Nevus ; Rehabilitation ; Seizures ; Sturge-Weber Syndrome*

Issues related to the control of seizures and bleeding, as well as behavioral management due to mental retardation, render dental treatment less accessible or impossible for patients with Sturge-Weber syndrome (SWS). A 41-year-old man with SWS visited a dental clinic for rehabilitation of missing dentition. A bilateral port-wine facial nevus and intraoral hemangiomatous swollen lesion of the left maxillary and mandibular gingivae, mucosa, and lips were noted. The patient exhibited extreme anxiety immediately after injection of a local anesthetic and required various dental treatments to be performed over multiple visits. Therefore, full-mouth rehabilitation over two visits with general anesthesia and two visits with target-controlled intravenous infusion of a sedative anesthesia were planned. Despite concerns regarding seizure control, bleeding control, and airway management, no specific complications occurred during the treatments, and the patient was satisfied with the results.
Adult ; Airway Management ; Anesthesia* ; Anesthesia, General ; Anxiety ; Dental Clinics ; Dentition ; Gingiva ; Hemorrhage ; Humans ; Infusions, Intravenous ; Intellectual Disability ; Lip ; Mouth Rehabilitation* ; Mouth* ; Mucous Membrane ; Nevus ; Rehabilitation ; Seizures ; Sturge-Weber Syndrome*

Ankylosed tooth is defined as 'the discontinuance of normal passive tooth eruption without any mechanical barrier'. Ankylosed tooth treatment is a challenge to dental clinicians. In treatment of maxillary molar ankylosis cases there are risks of oro-antral fistula, displacement of root fragments into the maxillary sinus, as well as the necessity for providing additional sinus bone augmentation for future implant placement. In this study, we suggested a new technique using a piezoelectric device and a lateral side approach to the maxillary sinus leading to the simultaneous removal of the ankylosed maxillary molar and sinus grafting for the purpose of implant site development.
Ankylosis ; Displacement (Psychology) ; Fistula ; Maxillary Sinus ; Molar ; Tooth ; Tooth Eruption ; Transplants