Views: 222 Author: Dream Publish Time: 2025-04-23 Origin: Site
Content Menu
● Understanding Nobel Biocare Abutment Screws and Their Fractures
>> Why Do Abutment Screws Break?
>> Common Locations of Screw Fracture
● Is It Possible to Remove a Broken Nobel Biocare Abutment Screw Without Damaging the Implant?
● Nobel Biocare Abutment Screw Removal: Tools and Techniques
>> Overview of the Nobel Biocare Abutment Screw Retrieval Kit
>> Technique 1: Simple Removal When the Screw Fragment is Rotatable
>> Technique 2: Advanced Removal When the Screw Fragment is Not Rotatable
● Step-by-Step Guide to Nobel Biocare Abutment Screw Removal
>> Procedure
● Tips and Precautions for Successful Screw Removal
● FAQ
>> 1. What is the Nobel Biocare abutment screw removal kit, and what does it include?
>> 2. Can the broken screw always be removed without damaging the implant?
>> 3. What should I do if the broken screw fragment is not rotatable?
>> 4. How can I check if the implant threads are damaged after screw removal?
>> 5. Are there alternative methods if I do not have access to the Nobel Biocare kit?
Dental implant technology has revolutionized tooth replacement, offering patients durable, functional, and esthetic solutions. Among the most trusted brands, Nobel Biocare implants stand out for their precision engineering and clinical success. However, like any mechanical system, complications can arise. One of the most challenging issues clinicians face is the fracture of an abutment screw inside the implant. This complication can threaten the implant's integrity and the success of the prosthetic restoration.
In this comprehensive article, we will explore the question: Can you remove a broken Nobel Biocare abutment screw without damaging the implant? We will delve into the causes of abutment screw fractures, the specialized tools and techniques for screw removal, step-by-step procedural guidance, and important tips to ensure safe and effective retrieval. Visual aids and video resources will be referenced throughout to enhance understanding. Finally, a detailed FAQ section will address common concerns.
In implant dentistry, the abutment screw is a small but critical component that connects the abutment (the part that supports the crown) to the implant fixture embedded in the bone. Nobel Biocare abutment screws are manufactured with high-quality titanium alloys designed to withstand masticatory forces and provide a stable connection.
Despite their strength, abutment screws can fracture under certain conditions:
- Over-torquing: Applying excessive torque during tightening can overstress the screw.
- Metal Fatigue: Repeated cyclic loading during chewing can cause microscopic cracks that propagate over time.
- Improper Seating: If the abutment is not seated correctly, uneven stress distribution can lead to screw failure.
- Manufacturing Defects: Though rare, material imperfections can weaken the screw.
- Bone Remodeling and Micro-Movements: Changes around the implant can alter load distribution, increasing screw stress.
The abutment screw often breaks at stress concentration points such as:
- The junction between the screw head and the shank
- The threaded portion where the screw engages the implant
When the screw fractures, the remaining fragment usually remains lodged inside the implant body, making removal challenging.
The short answer is yes—it is possible to remove a broken Nobel Biocare abutment screw without damaging the implant. However, the success depends on several factors:
- The condition and position of the broken screw fragment
- The availability of specialized removal tools
- The clinician's skill and experience
- The use of appropriate techniques to protect the implant threads
Nobel Biocare has developed a dedicated Abutment Screw Retrieval Kit designed specifically for this purpose. This kit includes instruments and guides that allow clinicians to safely remove broken screw fragments while preserving the implant's internal threads and structure.
The kit contains:
- Abutment Screw Removers: Tools with specially designed teeth to grip and rotate broken screws.
- Rescue Drill Guides: Protective sleeves that fit over the implant to shield threads during drilling.
- Reverse Drills: Drills that rotate counterclockwise to create a pilot hole in the screw fragment.
- Screw Retrieval Instruments: Tools that engage the pilot hole to unscrew the fragment.
- Thread Repair Tools: Screw taps to restore damaged internal threads.
- Handles and Torque Drivers: For manual or mechanical operation of the instruments.
If the broken screw fragment inside the implant can be rotated, removal is relatively straightforward:
1. Select the Correct Screw Remover: Based on the implant platform size (e.g., Narrow Platform, Regular, Wide).
2. Attach to Handpiece or Handle: Connect the remover to a low-speed handpiece or manual handle.
3. Engage the Screw Fragment: Position the remover's teeth onto the broken screw.
4. Rotate Counterclockwise: Apply gentle pressure and rotate at a speed not exceeding 50 rpm.
5. Extract the Screw: Once loosened, carefully remove the fragment.
This method is minimally invasive and preserves the implant threads.
If the screw fragment is stuck and cannot be rotated, a more advanced approach is necessary:
1. Attach the Rescue Drill Guide: This guide fits over the implant platform and protects the internal threads during drilling.
2. Select the Reverse Drill: Choose the drill size that matches the implant platform.
3. Drill a Pilot Hole: Using a handpiece in reverse mode (about 2000 rpm), drill approximately 1 mm into the screw fragment. The drill guide ensures precision and prevents damage.
4. Remove the Drill Guide: After drilling, take off the guide.
5. Insert the Screw Retrieval Instrument: Place the retrieval tool into the pilot hole.
6. Rotate Counterclockwise: Apply gentle pressure to unscrew the fragment.
7. Use Torque Driver if Needed: For added force, attach the retrieval tool to a torque driver.
This technique requires precision and care but is effective in retrieving non-rotatable fragments without harming the implant.
- Custom Guide Tube and Tungsten Carbide Bur: A custom-made guide tube can be used to protect the implant while a tungsten carbide bur drills into the screw fragment. This method is useful when the standard kit is unavailable or when additional precision is required.
- Manual Methods: Sometimes, clinicians use sharpened wooden sticks or dental floss to grip and rotate the fragment, especially if it is partially exposed.
- Slot Creation on Screw Head: If the screw head is stripped, creating a slot with a dental bur allows the use of a flat-head screwdriver to back out the screw.
- Nobel Biocare Abutment Screw Retrieval Kit
- Low-speed handpiece with speed control
- Irrigation system (saline or sterile water)
- Torque driver (optional)
- Magnification loupes or microscope
Step 1: Clinical Assessment
- Confirm the screw is fractured and determine if the fragment can be rotated.
- Identify the implant platform size to select the correct tools.
- Take radiographs to assess fragment position and implant condition.
Step 2: Simple Removal (If Rotatable)
- Attach the appropriate abutment screw remover.
- Engage the broken screw fragment.
- Rotate counterclockwise at ≤50 rpm with gentle pressure.
- Remove the fragment once loosened.
Step 3: Advanced Removal (If Not Rotatable)
- Place the rescue drill guide over the implant.
- Drill a pilot hole into the screw fragment using the reverse drill at ~2000 rpm.
- Remove the drill guide.
- Insert the screw retrieval instrument into the pilot hole.
- Rotate counterclockwise to unscrew the fragment.
- Use a torque driver if manual force is insufficient.
Step 4: Thread Evaluation and Repair
- Insert a new abutment screw to check for resistance.
- If resistance is felt, use the screw tap repair tool to restore damaged threads.
- Confirm smooth screw insertion.
Step 5: Prosthetic Restoration
- Place a new abutment screw.
- Proceed with the fabrication and placement of the prosthetic crown.
- Use Correct Tool Size: Always select screw removers and drills that match the implant platform to avoid damage.
- Control Speed and Pressure: Operate handpieces at recommended speeds and apply gentle pressure to prevent overheating or implant damage.
- Use Irrigation: Continuous irrigation during drilling prevents heat buildup, which can damage bone and implant.
- Protect Implant Threads: Use rescue drill guides or custom guide tubes to shield the implant's internal threads.
- Inspect After Removal: Always check the implant threads for damage and repair if necessary.
- Seek Specialist Help: If unfamiliar with screw removal techniques, refer to an experienced implantologist or oral surgeon.
Removing a broken Nobel Biocare abutment screw without damaging the implant is not only possible but can be routinely achieved with the right knowledge, tools, and technique. The Nobel Biocare Abutment Screw Retrieval Kit provides a comprehensive solution tailored to the implant system's design, enabling clinicians to manage this complication efficiently.
The key to success lies in careful assessment, using the appropriate removal method—simple rotation if possible or advanced drilling and retrieval when necessary—and protecting the implant threads throughout the process. With these measures, clinicians can preserve the implant's integrity, restore function, and maintain patient satisfaction.
The Nobel Biocare abutment screw removal kit is a specialized set of instruments designed to safely remove broken or stripped abutment screws from Nobel Biocare implants. It includes screw removers, reverse drills, rescue drill guides, screw retrieval instruments, and thread repair tools.
Most broken screws can be removed without implant damage if the correct tools and techniques are used. However, improper methods or excessive force can harm the implant threads, potentially compromising implant stability.
If the fragment is stuck, use the rescue drill guide and reverse drill to create a pilot hole in the screw fragment. Then, insert the screw retrieval instrument into the hole and rotate counterclockwise to remove the fragment.
Insert a new abutment screw gently into the implant. Resistance or difficulty indicates possible thread damage. Use a screw tap repair tool to restore threads before placing the final abutment.
Yes. Alternative methods include using sharpened wooden sticks, dental floss, or creating a slot on the screw head with a bur to remove the fragment manually. However, these methods carry higher risks and should be performed cautiously.
[1] https://store.nobelbiocare.com/ca/en/media/eifu/IFU1043_EN_GB_02.pdf
[2] https://uniqa.dental/cases/removing-broken-screw-dental-implant-guide-dentists/
[3] https://www.journalofosseointegration.eu/jo/article/download/502/358
[4] https://www.ddsgadget.com/fractured-screw-removal-tool-kit.html
[5] https://www.youtube.com/watch?v=f7zO0FgkqSM
[6] https://meridian.allenpress.com/joi/article/38/2/165/6732/A-Modified-Technique-for-Removing-a-Failed
[7] https://www.youtube.com/watch?v=LtvwS0HuUBg
[8] https://www.youtube.com/watch?v=IDh-a2Wr9fI
[9] https://www.osseonews.com/screw-fractured-on-nobel-replace-implant-which-technique-should-i-use-to-retrive-the-screw/
[10] https://www.nobelbiocare.com/en-int/rescue-instrumentation
[11] https://www.youtube.com/watch?v=HshtI53ByC8
[12] http://removpros.dentistry.dal.ca/ewExternalFiles/%20Nobel%20Abut%20Retrievl%20Conical%20Connection.pdf
[13] https://store.nobelbiocare.com/international/en/abutment-screw-retrieval-set
[14] https://www.sciencedirect.com/science/article/pii/S0022391322004668
[15] https://www.youtube.com/watch?v=t9Ir7MIaUAI
[16] https://store.nobelbiocare.com/dk/en/abutment-screw-remover-rp-wp-6-0
[17] https://www.yagudentaltech.com/what-tools-are-included-in-a-nobel-abutment-screw-retrieval-kit.html
[18] https://www.osseonews.com/screw-fractured-on-nobel-replace-implant-which-technique-should-i-use-to-retrive-the-screw/
[19] https://pmc.ncbi.nlm.nih.gov/articles/PMC4067798/
[20] https://www.osseoshop.com/products/screw-removal-kit
[21] https://www.perioimplantadvisory.com/clinical-tips/article/16412202/fractured-dental-implant-screw-complications-3-methods-for-screw-retrieval
[22] https://www.zestdent.com/locator-angled-abutment-for-nobel-biocare
[23] https://store.nobelbiocare.com/in/en/abutment-screw-retrieval-set
[24] https://www.youtube.com/playlist?list=PLeNbc7GBkhAqyKcOTnaMzovmLISVTjRS5
[25] https://www.youtube.com/watch?v=x_SNgKu3Clw
[26] https://www.dental-tribune.com/c/nobel-biocare-services-ag/prod/nobel-biocare-rescue-instrumentation/
[27] https://www.youtube.com/nobelbiocare
[28] https://edeldental.hu/images/pdf/procera_sales_brochure_en.pdf
[29] https://www.nobelbiocare.com/en-us/technical-support-frequently-asked-questions-faqs
[30] https://www.nobelbiocare.com/en-int/top-questions-frequently-asked-questions-faqs
[31] https://uniqa.dental/cases/removing-broken-screw-dental-implant-guide-dentists/
[32] https://www.eotdental.com/uploads/pdf/NobelParallel-Manual%20.pdf
[33] https://www.eotdental.com/uploads/pdf/trefoil.pdf
[34] https://www.osseonews.com/removing-a-cover-screw-on-nobel-biocare-replace-select-implant-any-ideas/
[35] https://dentallabnetwork.com/forums/threads/nobel-replace-loosening.7420/
[36] https://www.drritaharding.com/procedures/cosmetic-dentistry/nobel-biocare/
[37] https://www.youtube.com/watch?v=LtvwS0HuUBg
[38] https://www.youtube.com/watch?v=IDh-a2Wr9fI
[39] https://www.youtube.com/watch?v=BkfPZ1PUSCE
[40] https://store.nobelbiocare.com/ca/en/media/eifu/IFU1043_EN_GB_02.pdf
