Explantation of an Osseointegrated Titanium Implant Using Laser-Induced Thermo-necrosis: A Case Report

Explantation of fully or partially osseointegrated titanium implants is a complex procedure for myriad reasons and often results in major bone loss and pronounced defects of the hard and soft tissues. This may require more elaborate surgical interventions in cases of re-implantation. In this patient case, an osseointegrated titanium implant with some visible bone loss, missing attached mucosa at the buccal aspect, and a nonideal three-dimensional (3D) position had to be explanted. For this, the implant's inner connection was heated using a CO2 laser, which resulted in localized laser-induced thermo-necrosis at the bone-to-implant contact. One week following laser application, explantation could be performed easily with a torque slightly more than 35 Ncm. No complications occurred during the healing period. The result was a very easily performed explantation while preserving a maximum of the surrounding bony structure. Healing was uneventful, and no further visible bone loss could be observed during the healing time. Keywords: CO2 laser, explantation, implant, induced osteonecrosis, removal