Case Follow-up: To Implant or Not To Implant: What Role Does Imaging Play?
This case is presented by the University of Toronto, Department of Oral Radiology Residents: Edwin Chang, Sherif El Saraj, Catherine Nolet-Levesque, Daniel Turgeon, Niloufar Amintavakoli, and Trish Lukat. Pre-operative images provided courtesy of Dr. Milan Madhavji of Canaray | Specialists in Oral Radiology.
You can view the original case here.
Four implants were placed in the anterior mandible. Following implant surgery, the patient experienced persistent pain in the implant area and two of the implants failed in the immediate post-operative period.
Over the course of the following year, the pain progressively worsened in the anterior mandible and the patient was subsequently referred for a follow-up limited field-of-view cone beam CT assessment.
Axial cone beam CT cross-sectional image at the level of the mandibular alveolar process following implant placement
Rendered panoramic reconstruction from the cone beam CT data set.
Bucco-lingual cone beam CT cross-sectional images through the anterior mandible.
1. Why did two of the implants fail?
2. Why is the patient in chronic pain?
3. How has the radiographic appearance in the anterior mandible changed?
4. What do these clinical findings and radiographic features suggest?
5. Based on your deductions, would you have changed the original treatment plan? Why or why not?