Views: 222 Author: Dream Publish Time: 2024-12-21 Origin: Site
Content Menu
● Techniques for Removing a Broken Abutment Screw
>> 2. Creating a Purchase Point
>> 4. Using Screw Removal Kits
● FAQ
>> 1. What causes an abutment screw to break?
>> 2. Can I remove a broken screw myself?
>> 3. What tools are essential for removing a broken abutment screw?
>> 4. How do I know which technique to use?
>> 5. Are there risks involved in removing broken screws?
Removing a broken abutment screw can be a daunting task, especially for dental practitioners who may not have encountered this issue frequently. However, with the right techniques and tools, this procedure can be performed effectively. This article will guide you through the methods of removing a broken abutment screw, providing detailed steps, illustrations, and videos to enhance understanding.
Before diving into the removal techniques, it's essential to understand what an abutment screw is and why it might break. Abutment screws are critical components in dental implants, connecting the implant to the crown or prosthetic. They can break due to several reasons:
- Excessive torque during placement
- Material fatigue over time
- Improper fitting of components
- Undetected loosening prior to fracture
When an abutment screw breaks, it often leaves a fragment embedded in the implant, posing challenges for removal.
To successfully remove a broken abutment screw, you will need specific tools:
- Dental handpieces (high-speed and low-speed)
- Burs (round and flat)
- Screw removal kits
- Ultrasonic scaler
- Dental aspirator
- Tweezers or forceps
- Wooden sticks or cotton swabs
In addition to these basic tools, having a good lighting source and magnification (such as loupes) can significantly enhance visibility and precision during the procedure.
There are several techniques to remove a broken abutment screw. The choice of method depends on the location and condition of the broken screw fragment.
These methods are non-invasive and should be attempted first.
- Using a Dental Probe: If the fragment is slightly movable, use a sharp dental probe or a periodontal probe to gently tease it out in a counter-clockwise direction. This method is particularly useful if part of the screw is still exposed above the implant platform.
- Ultrasonic Scaling: An ultrasonic scaler can vibrate the remaining piece, potentially loosening it enough for removal. This technique is beneficial when dealing with small fragments that are difficult to grasp.
If conservative methods fail, you may need to create a purchase point.
- Drilling a Slot: Use a low-speed handpiece with a 1/4 round bur to create a slot across the top of the broken screw. This slot allows you to use a flat-tip screwdriver to back out the fragment.
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1. Place the bur on the fragment.
2. Rotate at low speed while applying gentle pressure.
3. Create a slot deep enough for the screwdriver.
Creating this slot requires careful attention to avoid damaging surrounding tissues or components of the implant system.
This method involves using specialized kits designed for screw removal.
- Reverse-Tap Drills: Attach a reverse-tap drill to your handpiece and carefully drill into the center of the broken screw fragment. This creates threads that allow for easy unscrewing.
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1. Insert the reverse-tap drill into the handpiece.
2. Drill at low RPM (70–80) in reverse mode.
3. Monitor closely to avoid damaging surrounding structures.
The reverse-tap technique is particularly effective when dealing with screws that have sheared off at or below the level of the implant platform.
These kits typically include various tools specifically designed for extracting broken screws.
- Screw Extractor Tool: Insert this tool into the channel of the broken screw and turn counter-clockwise until it grips the fragment tightly enough to pull it out. These kits often come with multiple sizes of extractors, allowing you to choose one that best fits your situation.
If all else fails, more aggressive methods may be necessary.
- High-Speed Handpiece with Diamond Bur: Use this tool to carefully grind away at the remaining screw material until you can access it adequately for removal. This method should only be used as a last resort due to its invasive nature.
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1. Select an appropriate diamond bur.
2. Use high-speed settings while maintaining control.
3. Carefully grind around the fragment without damaging surrounding structures.
After successfully removing the broken abutment screw, it's crucial to assess any potential damage caused during removal:
- Inspect Surrounding Tissues: Check for any signs of trauma or inflammation around the implant site.
- Evaluate Implant Integrity: Ensure that there are no fractures or damage to the implant itself.
- Consider Replacement Options: Depending on how much damage was sustained during removal, you may need to replace both the abutment and possibly even the implant.
For visual learners, watching video tutorials can be incredibly helpful:
These videos provide practical demonstrations that complement the written instructions above.
Removing a broken abutment screw requires patience and precision. By following these outlined techniques and utilizing appropriate tools, practitioners can effectively address this common issue in dental implant procedures. Always start with conservative methods before progressing to more invasive techniques, ensuring minimal damage to surrounding structures.
Abutment screws may break due to excessive torque during placement, material fatigue, improper fitting, or undetected loosening prior to fracture.
It is advisable for only trained dental professionals to attempt removing broken screws due to potential complications that can arise from improper handling.
Essential tools include dental handpieces (high-speed and low-speed), burs (round and flat), ultrasonic scalers, dental aspirators, and specialized screw removal kits.
Start with conservative techniques such as probing or ultrasonic scaling; if these fail, move on to creating purchase points or using specialized kits based on your assessment of the situation.
Yes, there are risks including damaging surrounding tissues or structures if proper care is not taken during removal procedures.
[1] https://uniqa.dental/cases/removing-broken-screw-dental-implant-guide-dentists/
[2] https://www.perioimplantadvisory.com/clinical-tips/article/16412202/fractured-dental-implant-screw-complications-3-methods-for-screw-retrieval
[3] https://www.youtube.com/watch?v=ZFW1Glje3Fk
[4] https://www.youtube.com/watch?v=IDh-a2Wr9fI
[5] https://www.speareducation.com/spear-review/2016/11/3-techniques-to-remove-broken-abutment-screws
[6] https://www.straumann.com/content/dam/media-center/medentika/en-us/documents/brochure/USLIT.2182-Medentika-Rescue-Kit.pdf
[7] https://www.dentistryiq.com/practice-management/article/16357225/clinical-tip-how-to-easily-remove-broken-abutment-screws-in-dental-implants
[8] https://www.youtube.com/watch?v=MDg8br2WNps
[9] https://www.youtube.com/watch?v=NhSGExGIyQI
