Clinical Report
An alternative approach for the management of fractured implant abutment screws on a mandibular implant-retained overdenture: A clinical report

https://doi.org/10.1016/j.prosdent.2015.09.027Get rights and content

Abstract

In contemporary implant and prosthodontic practice, high levels of surgical and biologic success rates have been achieved. However, mechanical and technical complications continue to exist. Of these, one of the biggest challenges to the clinician is the conservative retrieval of fractured screw fragments from within the implants and/or abutments. While removal is desirable, the fragments cannot always be removed, and alternative solutions for the management of such clinical situations must be considered. This clinical report describes the replacement of 2 fractured, irretrievable, Locator abutment screws of a mandibular implant-retained overdenture with a cast dowel and laser welded Locator attachments. This alternative method was successful in managing broken abutment screw fragments while using the existing prosthesis and implants.

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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