Clinical ReportAn alternative approach for the management of fractured implant abutment screws on a mandibular implant-retained overdenture: A clinical report
Section snippets
Clinical Report
A 64-year-old man presented to the Advanced Prosthodontics clinic with a loose mandibular IOD. The patient had a maxillary fixed complete denture and a mandibular IOD for 4 years. Clinical examination showed that both Locator abutment screws were fractured within the implants (Fig. 1). The fractured abutments (female) remained attached to the denture. Screw removal was attempted using known clinical techniques such as a sharp explorer, probe, ultrasonic scaler at low vibrations in reverse
Discussion
Although retrieving a fractured screw and replacing it with a new one without any damage to the internal threads of the implant is the recommended solution, in some situations, the fractured screw cannot be removed.18 When all the screw retrieval techniques fail, the approach described here may be the best compromise. It represents a conservative, easy to perform, cost-effective, and time-efficient, nonsurgical solution. Nevertheless, the purpose of this technique should be to avoid any further
Summary
This clinical report describes a patient with IOD and fractured Locator abutments. Multiple attempts to retrieve the broken screw fragments were unsuccessful and possibly resulted in minor damage to the right implant’s internal threads. It was then decided to fabricate custom laser-welded Locator attachments to allow continued use of the mandibular denture without sacrificing the implants. After PVS impression, custom laser-welded Locator attachments were fabricated from the stone cast. These
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Retrieval of a fractured implant abutment using a modified cover screw removal instrument: A clinical report
2023, Journal of Prosthetic DentistryRetrieval of a fractured implant abutment screw using a microtube extraction device: A dental technique
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2021, Journal of Prosthetic DentistryCitation Excerpt :Selecting low-speed rotary instruments (burs and drills) of various lengths for modification, screw fragments can also be reached inside the implant. An important advantage of this technique is the elimination of drilling systems for fragment removal5 and the application of reverse torque with a rachet.1 Limitations include the difficulty in forming the receptor notch when the fractured surface has been damaged by previous retrieval attempts.
Alternative approach to salvaging an implant with a fractured screw fragment: A clinical report
2021, Journal of Prosthetic DentistryClinical assessment of fractured implant abutment screws: The Bernese silicone replica technique
2018, Journal of Prosthetic DentistryA risk-based decision making tree for managing fractured abutment and prosthetic screws: A systematic review
2018, Journal of Prosthetic DentistryCitation Excerpt :Furthermore, there is a high risk of heat generation whenever screws are drilled, and for that reason, drilling should be performed intermittently at a reduced speed with copious irrigation.25,29 In situations where removal of the screw fragments is not possible using a low- or moderate-risk technique, intentional modification of the implant may be necessary to keep the implant serviceable.36-46 If the internal aspect of the implant is significantly damaged or the screw fragment is irretrievable, the clinician may choose to remove the implant and place a new one.