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Should I Remove Titanium Screws to Hold Block Graft in Place?

posted in Bone Grafting, advice

« Dental Implant Spinning in Socket: How to Manage? | Treating a Fractured Implant Fixture? »

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Dr. T. asks:
I performed a block bone graft with the hopes of having enough vertical and horizontal bone augmentation on the deficient alveolar ridge for placing implants in #6 and #7 sites [maxillary right canine and lateral incisor]. According to the CT scan, the bone is thin and is lacking in density. I’m not sure if I will be able to achieve primary stability. If not, do I have to go back in and to remove the titanium screws that I used to hold the block graft in place? What would happen if they are left in place? If I cannot place the implants, I do not want to do another surgery if I can avoid it.

8 Responses to “ Should I Remove Titanium Screws to Hold Block Graft in Place? ”

• sb oral surgeon July 14th, 2009

  
  

  No disrespect here, but are you trained in the management of block grafts? Vertical augmentation in the anterior maxilla is THE most difficult reconstructive procedure to do correctly. From your questions it appears that the viability of your graft is questionable. What was the source of your graft? Fixation screws do not need to come out unless they interfere with implant placement. Sounds like you need to go over your scan with an experienced practioner.

• mike stanley, asst. July 14th, 2009

  
  

  That’s probably why we refer them out….

• Don Callan July 15th, 2009

  
  

  Refer this case out.

• jon July 21st, 2009

  
  

  Refer the case and pray you do not get sued by the patient if you are not sure what to do about this. Refer to someone you can trust.

• Richard Hughes DDS, FAAID, FAAIP, Dipl.ABOI/ID July 22nd, 2009

  
  

  Providing you made a good receptor site for the graft and you intend to place implants, give it anout six to eight months, then back out the screws.

• Ofer Moses August 1st, 2009

  
  

  Do not it befor placing the implants unless its presence interferes with impalnt path of insertion.
  There is a danger of block detachment after healing period due to the fact that implants are wider that the final drill in 0.5 mm.

• Dr. Hack August 16th, 2009

  
  

  Why not go ahead and use a mini implant they seem to be the cure all, and you can probably maintain the graft and get an implant into it. Just cure a denture tooth on the mini implant for the crown. You probably wont even have to raise a flap.

• Richard Hughes DDS, FAAID, FAAIP, Dipl.ABOI/ID August 17th, 2009

  
  

  Remove the Ti screws after 8 months. Feel for the screw and make a vertical incision (no scar).

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