Patients today often present with existing dental implants. When there is a need to incorporate existing implants into patient’s treatment plan, this poses a clinical challenge especially for implants that are unserviceable due to unfavorable position or implant systems that do not have readily available components.

Clinical examination revealed malpositioned implants and open gaps between the implant abutments and platforms. Implants #3,12,13 and 16 were deemed unfavorable and planned to be explanted while existing implant restoration over #51,1,2 were modified to serve as a healing abutment to retain implants #51,1,2. Retention of #51,1,2 was decided based on lack of active peri-implant disease, proximity to the sinus, and morbidity of bone loss due to explantation of 3 implants in close proximity.

This case report demonstrates treatment plan decisions for patients with non-ideal existing implants and how existing implants without available components can be managed. The modification process involves identifying the screw configuration, verifying the fit of the restoration, and adjusting the prosthesis into hygienic design.

This case demonstrates the clinical challenges associated with malpositioned or non-FDA approved implants lacking compatible components in the US. Through careful assessment of implant health, anatomical considerations, and prosthetic limitations, alternative approach was implemented by modifying existing restorations into healing abutments, thereby preserving implants to minimize surgical morbidity.