Purpose:
Inferior alveolar nerve injury, peri-implantitis, sinus complications, and multiple implant failures can significantly compromise oral function and quality of life. This case report presents the long-term management of a patient with severe implant-related complications and demonstrates the effectiveness of a staged rehabilitation strategy.

Case Presentation:
A 59-year-old woman presented with persistent hypoesthesia of the left mandible following implant placement. Imaging revealed perforation of the inferior alveolar nerve canal by implants as well as extensive implant failures in both jaws. Treatment included atraumatic implant removal, staged alveolar ridge augmentation using allogenic bone grafts, sinus floor elevation, and sequential placement of Luna® implants. Additional management of chronic osteomyelitis was performed where necessary. The rehabilitation process extended over approximately six years.

Results:
Progressive recovery of sensory function was observed following removal of the malpositioned implants. Radiographic follow-up demonstrated stable osseointegration, successful bone regeneration, and maintenance of ridge contours in both the maxilla and mandible. Chronic osteomyelitis was successfully resolved, and long-term implant stability was maintained throughout follow-up.

Conclusion:
This case illustrates that even highly compromised implant cases involving nerve injury and severe peri-implantitis can be successfully managed through a carefully staged rehabilitation protocol. Confirming the success of each treatment phase before proceeding to the next contributed to favorable long-term outcomes. The report highlights the importance of meticulous planning, interdisciplinary collaboration, and patient compliance in complex implant rehabilitation.