Immediate Reconstruction of Failed Implants in the Esthetic Zone Using a Flapless Technique and Autogenous Composite Tuberosity Graft

We describe a technique for immediate reconstruction of bone after removal of failed dental implants in the esthetic region to optimize the esthetic outcome of retreatment. We conducted a study of 16 consecutive patients in whom the bony defect resulting from implant removal was immediately reconstructed with a combined autogenous bone and soft tissue graft harvested from the maxillary tuberosity. After a healing period of 3 months, implants were inserted. At 1 year after placement of the definitive restoration, no implants had been lost, the peri-implant tissues were healthy, the aesthetics scored with the pink esthetic score were favorable, and the patients were satisfied. With this technique, it appears that immediate reconstruction of the hard and soft tissue components with a combined bone-soft tissue graft after removal of an implant is a feasible treatment option, from the perspective of both patients and professionals. It expedites rehabilitation, reduces morbidity, and results in a favorable esthetic outcome. (C) 2017 American Association of Oral and Maxillofacial Surgeons