Immediate Full‐Arch Implant Rehabilitation Through an Impacted Maxillary Canine: A 5‐Year Case Report

ABSTRACT

A deeply impacted tooth within a planned implant trajectory may complicate implant‐supported rehabilitation. Intentional transdental implant placement has been proposed as an alternative to extraction in selected patients. A 55‐year‐old woman with generalized advanced periodontitis, bruxism, and heavy tobacco use underwent bimaxillary fixed rehabilitation. Preoperative cone‐beam computed tomography (CBCT) analysis identified a deeply impacted maxillary left canine within the planned implant trajectory. Extraction was expected to create a substantial ridge defect that could compromise primary implant stability and necessitate augmentation and delayed implantation. Eleven implants were placed, including a 4.0 × 16 mm implant at position 25, inclined at 30° so that its apical portion traversed the impacted canine at position 23. All implants achieved insertion torque > 45 Ncm. Screw‐retained provisional full‐arch prostheses were delivered in full occlusal contact on postoperative Day 2 and definitive prostheses at 2 months. Analysis of the 2.5‐year CBCT identified crestal bone within 1 mm of the transdental implant shoulder. At 5 years, the implant remained asymptomatic, without clinical signs of peri‐implant inflammation. Qualitative panoramic assessment identified no pathology at the implant–tooth interface. Canine vitality remained undetermined, and no histological assessment was available. These findings do not establish dentointegration or quantify longitudinal bone‐level change.