Proposal and In-Depth Analysis of Emergency Treatment Procedures for Removing Fractured Abutments in Implants With Tapped-In Connections: Case Report
In implant-supported prostheses, the most frequently reported mechanical complications after implant restoration are loosening or fracture of abutments or screws. Such complications have serious consequences, and removal of fractured abutments or screws is difficult. There are various methods to remove fractured abutment screws in implants with screwed-in connections. However, no approach has been reported to retrieve solid abutments in implants with a locking-taper implant-abutment connection, which are rarely observed in clinical settings. This study presents the case of a 62-year-old male patient with a fractured abutment in an upper-right second premolar implant. Abutment fracture is a common mechanical complication after dental implantation. Parafunctional habits and occlusal overloading may generate excessive occlusal forces, which increase the risk of mechanical complications. This report presents a series of emergency procedures for removing a fractured solid abutment and fabricating a new prosthesis to restore the edentulous area. In this retrospective analysis, the authors deeply consider the whole treatment, through which the deficiencies of the treatment are noted, and corresponding future directions are discussed. This case report presents a convenient approach to removing a solid abutment in a sudden emergency, discusses possible reasons for solid abutment fractures, designs a new rescue kit for easy retrieval of such abutments and summarizes a valid solution for removing fractured solid abutments.
Figure 1. (a) Fractured abutment fragments of the implant in the clinical examination. (b) Broken abutment with crowns. Figure 2. Radiographic examination. Figure 3. (a) A slender fissure bur in a high-speed handpiece. (b) A linear access hole from the center of the fractured abutment to near the abutment margin. Figure 4. (a) An extender with a flat and thin cusp. (b) Inserting the extender into the linear access hole on the abutment to move the fractured abutment.
Figure 5. Broken abutment fragments. Figure 6. Yttria-stabilized zirconia crowns. Figure 7. Occlusal view of the final prosthesis. Figure 8. Periapical radiograph showing the implant after 1 year of use. Figure 9. (a) Design of a new rescue kit used when the site of the solid abutment fracture is deep. (b) Design of a new rescue kit used when the site of the solid abutment fracture is above the implant-abutment interface.
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