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Journal of Prosthetic Dentistry

A technique for removing a fractured 1-piece titanium abutment

Published:September 27, 2017DOI:https://doi.org/10.1016/j.prosdent.2017.06.025
      The fracture of the dental implant abutment may represent a serious problem as the fragment remaining inside the implant may compromise the performance of the prosthesis if not removed.
      • Nergiz I.
      • Schmage P.
      • Shahin R.
      Removal of a fractured implant abutment screw: a clinical report.
      An important consideration is to avoid damaging the internal threads of the implant,
      • Imam A.Y.
      • Moshaverinia A.
      • Chee W.W.
      • McGlumphy E.A.
      A technique for retrieving fractured implant screws.
      and different methods of fractured screw fragment retrieval have been described.
      • Imam A.Y.
      • Moshaverinia A.
      • Chee W.W.
      • McGlumphy E.A.
      A technique for retrieving fractured implant screws.
      • Agustín-Panadero R.
      • Labaig-Rueda C.
      • Castillo-Rodriguez B.
      • Ferreiroa A.
      • Fernanda Solá-Ruíz M.
      In vitro evaluation of three methods for the retrieval of fractured screw fragments from dental implants.
      • Barbosa J.M.
      • Ascenso J.
      • Hirata R.
      • Caramês J.
      The cotton driver: an alternative technique for removing fractured screw fragments.
      • Saponaro P.C.
      • Lee D.J.
      • McGlumphy E.A.
      Managing a fractured one-piece zirconia abutment with a modified plastic periodontal probe: a clinical report.
      • Johnston G.R.
      • Jamjoom F.Z.
      • Lee D.J.
      A technique for the removal of a wedged implant abutment fragment or debonded titanium base.
      The purpose of this article was to introduce a procedure for removing a fractured 1-piece titanium abutment without damaging the internal area of the implant thread.

      Procedure

      • 1.
        Confirm the fracture of the 1-piece titanium abutment (Fig. 1).
        Figure thumbnail gr1
        Figure 1Fractured 1-piece titanium abutment. A, Occlusal view of remaining fragment. B, Radiograph showing fractured fragment.
      • 2.
        Cut a section of sterilized rubber band and place it into the threaded internal chamber of the implant (Fig. 2A). The section of rubber band should be approximately 1.5×1.5×1.5 mm, about the size of the chamber (Fig. 2B).
        Figure thumbnail gr2
        Figure 2Removal technique. A, Suitable rubber band. B, Piece of rubber band placed into implant. C, Screwdriver placed on top of rubber band.
      • 3.
        Insert an implant screwdriver in a torque wrench into the implant and rotate counterclockwise under strong downward finger pressure (Fig. 2C). The pressure should be firm, with the thumb placed on the head of the driver. The slice of rubber band interposed between the driver and the fragment will create sufficient friction to loosen the fractured screw fragment. The rubber band may lodge in the implant but can be removed with an explorer.
      • 4.
        Use an explorer (Fig. 3A) or cotton drive
        • Barbosa J.M.
        • Ascenso J.
        • Hirata R.
        • Caramês J.
        The cotton driver: an alternative technique for removing fractured screw fragments.
        to remove the loosened fragment (Fig. 3B).
        Figure thumbnail gr3
        Figure 3A, Explorer twisted counterclockwise. B, Removal of fractured screw fragment.

      References

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        • Schmage P.
        • Shahin R.
        Removal of a fractured implant abutment screw: a clinical report.
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        • Imam A.Y.
        • Moshaverinia A.
        • Chee W.W.
        • McGlumphy E.A.
        A technique for retrieving fractured implant screws.
        J Prosthet Dent. 2014; 111: 81-83
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        • Labaig-Rueda C.
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        In vitro evaluation of three methods for the retrieval of fractured screw fragments from dental implants.
        Int J Oral Maxillofac Implants. 2017; 32: e119-e124
        • Barbosa J.M.
        • Ascenso J.
        • Hirata R.
        • Caramês J.
        The cotton driver: an alternative technique for removing fractured screw fragments.
        J Prosthet Dent. 2014; 112: 1601-1602
        • Saponaro P.C.
        • Lee D.J.
        • McGlumphy E.A.
        Managing a fractured one-piece zirconia abutment with a modified plastic periodontal probe: a clinical report.
        J Prosthet Dent. 2017; 117: 587-591
        • Johnston G.R.
        • Jamjoom F.Z.
        • Lee D.J.
        A technique for the removal of a wedged implant abutment fragment or debonded titanium base.
        J Prosthet Dent. 2018; 119: 29-32