Innovative Problem Solving in Implant Dentistry: A Case Report on Adapting to Unknown Systems Through CAD-CAM Technology—2 Years Follow Up

Dental implants are a reliable option for replacing missing teeth; however, complications may arise when the implant system is unknown, limiting access to compatible restorative components. This case report describes the management of a 55-year-old female patient who presented with a missing cement-retained crown on a mandibular first molar implant of unknown origin. Clinical and radiographic examination confirmed a healthy peri-implant environment, but identification of the implant system was unsuccessful. To overcome this challenge, the existing titanium abutment was removed and analyzed. A discarded implant with a compatible fit was identified and used as a substitute analog. A customized coping was fabricated using CAD-CAM technology and utilized as an impression post to capture accurate details. A screw-retained zirconia crown was subsequently fabricated and successfully delivered. The restoration demonstrated excellent clinical stability, proper occlusion, and satisfactory esthetics. A 2-year follow-up confirmed healthy peri-implant tissues, stable bone levels, and absence of complications. This case highlights the importance of innovative problem-solving and interdisciplinary collaboration in managing unknown implant systems. Converting to a screw-retained restoration provided improved retrievability and reduced biological risks, offering a conservative and effective long-term solution.