Implant placement beyond osseointegration: A case report highlighting the importance of prosthetic, periodontal, and surgical treatment planning

Background: Dental implant therapy has revolutionized the replacement of missing teeth, with long-term success rates exceeding 90% when appropriate treatment planning and surgical execution are employed. While osseointegration remains the cornerstone of implant success, it alone does not guarantee long-term biological, prosthetic, or functional outcomes. Proper implant placement should be prosthetically, periodontally, and surgically driven to ensure predictable rehabilitation. This case highlights the consequences of implant placement that failed to satisfy these fundamental principles. Case Presentation: A 58-year-old medically healthy female presented with the chief complaint of dislodgement of a three-unit fixed partial denture in the maxillary right posterior region. Clinical examination revealed complete soft tissue coverage of the implant abutment. Radiographic evaluation demonstrated a malpositioned implant placed in close proximity to the distal root of the maxillary second premolar with the implant apex lying close to the floor of the maxillary sinus. Clinical mobility confirmed complete loss of osseointegration. Considering the poor prognosis, the implant was atraumatically retrieved while preserving the surrounding alveolar bone for future implant rehabilitation.Conclusion: This case demonstrates that implant success extends beyond achieving osseointegration. Comprehensive diagnosis, CBCT-based planning, prosthetically driven positioning, preservation of peri-implant tissues, and meticulous surgical execution are indispensable for long-term implant success.