A Modified Technique for Removing a Failed Abutment Screw From an Implant With a Custom Guide Tube
Fracture of abutment screw is a serious prosthodontic complication. When the abutment screw is fractured at the junction of the screw shank and screw thread, removal of the fractured screw fragment from the screw hole can be difficult. This article describes a modified technique for removing the failed abutment screw with a custom guide tube and tungsten carbide bur. The failed screw can be removed speedily without damaging the screw hole of the implant body or the screw threads.
Figure 1. Schematic illustration of an abutment screw. Figure 2. Pretreatment view of the patient showed that an angled abutment had been placed. Figure 3. Radiograph demonstrated that the failed abutment screw (arrow) remained in the screw hole of the implant. Figure 4. The head side of the failed abutment screw.
Figure 5. The guide tube prepared for high-speed hand piece. Figure 6. The guide tube and tungsten carbide bur were inserted in the screw hole successively. Figure 7. Schematic illustration of the drilling procedure. Figure 8. The hole (arrow) drilled in the center of the failed abutment screw.
Figure 9. Retrieval Instruments for Branemark System (Nobel Biocare). Figure 10. The failed abutment screw and abutment were successfully replaced with a custom abutment. Figure 11. Radiograph showed that the connection of the implant body, the replaced abutment, and the new abutment screw were fine. Figure 12. The fabricated porcelain fused metal prosthesis was tried on the custom abutment.
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