title: Application of modified bony lid technique to remove or replace compromised implants: case series.
abstract: OBJECTIVE
  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.
  
  
  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.
authors.affiliation: VA Medical Center in Detroit, Michigan, University of Michigan, School of Dentistry, Ann Arbor, MI 48109-5503, USA. srjung@umich.edu
authors.forename: Soong-Ryong
authors.initials: SR
authors.lastname: Jung
authors.forename: Jill D
authors.initials: JD
authors.lastname: Bashutski
authors.forename: Michael L
authors.initials: ML
authors.lastname: Linebaugh
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D059605:Dental Implant-Abutment Design; D003758:Dental Implantation, Endosseous / Q000379:methods*; D015921:Dental Implants / Q000009:adverse effects*; D019250:Dental Implants, Single-Tooth; D019232:Dental Restoration Failure; D020878:Device Removal / Q000379:methods*; D004868:Equipment Failure; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation
chemical_list: D015921:Dental Implants