Non-invasive removal of sandblasted and acid-etched titanium palatal implants, a retrospective study

Short, rough-surfaced palatal implants are an established and reliable anchor for orthodontic treatment. Until recently, removal was only possible surgically using a hollow cylinder trephine. This standard method retrieves the implant combined with a larger bone volume and is therefore considered invasive and has known complications. Lately, an explantation tool which allows a sufficient force application to break the bone-implant-connection and unscrew the palatal implant was developed and, since its introduction, has been used as the method of choice in several orthodontic offices. The aim of this study was to assess the complications caused by removing rough-surfaced palatal implants simply by unscrewing them with an explantation tool in contrast to standard protocol by surgical removal with a trephine. The removal of 73 palatal implants using a customized explantation tool has been evaluated retrospectively and was compared to an existing sample of 44 conventional surgical explantations. The new clinical procedure resulted in successful removal of 71 (97.3 per cent) palatal implants. In two cases, the new method failed but removal with the established surgical method was still possible with no further complications. The non-invasive palatal implant removal with a customized explantation tool had less medical complications compared to an existing sample of surgical explantations. User's opinion was that the new method is more easily executed, less invasive, and also applicable without local anaesthesia. Therefore, it is considered to be beneficial for patients and the treatment approach of choice. However, further research is needed for verification.