A unique and challenging case

This photo is from 2011, featuring a 57-year-old male patient this year.

Due to discomfort in the area of tooth #26, various treatments including root canal therapy were attempted. However, eventually, the decision was made to extract the tooth and a simple implant was placed in the #26 area.

After a short period, following the extraction of the tooth in the #47 region, an implant was also placed.

This is a photo from 2012. However, the patient began complaining of neuropathic pain in the #26 area about one month after surgery. The symptoms included a burning sensation and intermittent pain.

An implant was placed without bone grafting, minimal soft tissue manipulation, and no maxillary sinus elevation. This is perplexing as there were no signs of infection around the implant

The symptoms were persistently treated, and the patient sought diagnosis from a traditional Korean medicine clinic and a dental school in Seoul. However, the cause remained elusive

During this time, the lower jaw was restored with prosthetics, and a temporary restoration was applied to tooth #26

Although titanium allergy was considered, there were no issues in the #46 area. According to the patient's account, they have been seeking opinions from various sources.

After discussing with several experts, it has been suggested, possibly by Professor Lee at Seoul National University, that there might be a slight proliferation of nerve cells around the implant, which could be the cause

In the end, the patient returned after two years without any symptoms, and the discomfort had resolved

This is a photo from 2014. Ultimately, an agreement was reached not to charge for further treatment in the case of tooth #26

However, in 2015, there was a loss of osseointegration in the implant at position #47, leading to its removal.

Subsequently, approximately 3 months later, a TS 5.0 10mm implant was placed, and about 4 months later, the restoration was carried out

This is a photo from 2016

However, after 6 years, there is pain and slight mobility in the area of tooth #47. To assess the situation, it was decided to remove the upper restoration and wait for about 3 months

But, the implant was eventually removed. It doesn't seem to be peri-implantitis, but it appears that osseointegration was compromised again after 6 years.

During this time, the patient had implants placed in other areas, such as in positions #37 and #21, and patient visited us for follow-up care.

The exact cause of the failure in position #47 is not precisely known. Occasionally, experiences of mutual discomfort like this can happen.

It seems that we need to reconsider starting again with the area of tooth #47.