Bone Regeneration Following Implant Failure Using the Khoury Technique: A Case Report

Implant retreatment following implant failure represents a biologically and technically demanding scenario, particularly in the esthetic zone. Sites of previous implant failure are frequently characterized by residual inflammation, altered bone physiology, and reduced regenerative potential, which may negatively affect the prognosis of replacement implants. A staged, biologically driven approach is therefore recommended to restore hard and soft tissues prior to implant replacement. This clinical case report describes the management of a compromised anterior maxillary site following implant failure using the Khoury technique with exclusive autogenous bone. A young female patient presented with significant esthetic impairment caused by improper implant placement performed earlier, resulting in excessive gingival display and inadequate prosthetic conditions. After atraumatic implant removal and site debridement, three-dimensional bone reconstruction was performed using thin cortical bone plates harvested from the mandibular retromolar area to stabilize autogenous particulate bone, without the use of biomaterials or barrier membranes. Implant placement was performed four months after augmentation in regenerated vital bone, allowing correct three-dimensional prosthetic positioning. Soft tissue optimization was achieved using a connective tissue graft. The patient was followed clinically and radiographically for up to seven years after implant placement. The long-term outcomes demonstrated stable peri-implant hard and soft tissues, satisfactory esthetic integration, and maintenance of regenerated bone volume over time. Within the limitations of a single case report, this clinical presentation supports the use of a staged autogenous bone-based regenerative approach for the management of extensive bone defects following implant failure in sites with compromised local biology.