Views: 222 Author: Dream Publish Time: 2025-04-23 Origin: Site
Content Menu
● Understanding the Nobel Active Abutment Screw
● Common Causes of a Stripped Nobel Active Abutment Screw
● Essential Tools and Kits for Removing Stripped Nobel Active Abutment Screws
>> Nobel Biocare Abutment Screw Retrieval Kit
>> Custom Guide Tubes and Tungsten Carbide Burs
● Step-by-Step Guide to Removing a Stripped Nobel Active Abutment Screw
>> Step 1: Initial Clinical Assessment
>> Step 2: Simple Removal Using Screw Remover
>> Step 3: Advanced Removal Using Rescue Drill Guide and Reverse Drill
>> Step 4: Creating a Slot on the Screw Head
>> Step 5: Removing Fractured Screw Fragments
● Best Practices and Tips for Successful Removal
● FAQ
>> 1. What causes a Nobel Active abutment screw to become stripped?
>> 2. Can I remove a stripped Nobel Active abutment screw without a specialized kit?
>> 3. How do I select the correct screw remover for a Nobel Active implant?
>> 4. What if the screw fragment inside the implant is not rotatable?
>> 5. How do I repair damaged implant threads after screw removal?
Removing a stripped abutment screw from a dental implant can be a daunting task, especially when dealing with the Nobel Active implant system. The Nobel Active abutment screw plays a crucial role in securing the abutment to the implant fixture, ensuring the stability and longevity of the prosthetic restoration. When this screw becomes stripped, damaged, or fractured, it can pose significant challenges for dental professionals. This comprehensive guide will provide you with detailed, step-by-step instructions, practical tips, and visual aids to help you safely and effectively remove a stripped Nobel Active abutment screw.
The Nobel Active abutment screw is engineered specifically for the Nobel Active implant system, which is known for its unique tapered design and aggressive thread pattern that promotes primary stability. The abutment screw fastens the prosthetic abutment to the implant body, providing a secure connection that withstands occlusal forces during mastication.
Due to its small size and critical function, any damage to the screw head—such as stripping of the hex or star-shaped recess—can make removal difficult without risking damage to the implant itself. Understanding the design and mechanical properties of the Nobel Active abutment screw is essential before attempting removal.
Knowing why a Nobel Active abutment screw becomes stripped helps in both prevention and management. Common causes include:
- Over-tightening: Applying excessive torque beyond manufacturer recommendations can deform the screw head.
- Cross-threading: Improper alignment during insertion can damage the threads and screw head.
- Corrosion and wear: Long-term exposure to oral fluids and mechanical forces can degrade the screw.
- Incompatible tools: Using drivers or wrenches not designed for Nobel Active screws can strip the recess.
- Debris or cement remnants: Obstruction can prevent full seating, causing uneven torque and damage.
Specialized tools are indispensable for dealing with stripped abutment screws. Here are the most effective kits and instruments:
This official kit is tailored for Nobel Active and other Nobel Biocare implants. It includes:
- Rescue drill guides designed to center drills precisely over the screw.
- Reverse drills to safely drill into the screw head.
- Screw retrieval instruments with gripping teeth.
- Torque drivers and handles for controlled application of force.
A versatile kit compatible with multiple implant systems, including Nobel Active. It contains:
- Various sizes of screw removers.
- Flat tip drivers for slotting techniques.
- Drill guides and burs for controlled drilling.
Used for precise drilling into the screw head, these burs allow clinicians to create a pilot hole or slot without damaging the implant threads.
Quarter round burs or small carbide burs can be used to create a slot on the screw head, enabling the use of a flathead screwdriver when specialized kits are unavailable.
Before any intervention, carefully assess the situation:
- Visual Inspection: Use magnification loupes and adequate lighting to examine the screw head.
- Attempt Gentle Removal: Try rotating the screw counterclockwise with the original Nobel Active screwdriver or compatible drivers.
- Radiographic Evaluation: Confirm screw position and check for fractures or implant damage.
If the screw shows minimal damage and rotates slightly, simple removal may be possible.
If the screw is stripped but still rotatable:
- Select the appropriate abutment screw remover based on the implant platform (Nobel Active Narrow Platform (NP) or Regular Platform (RP)).
- Attach the remover to a slow-speed handpiece or manual handle.
- Place the remover on the screw head, ensuring a secure grip.
- Rotate counterclockwise at a maximum of 50 rpm with gentle pressure.
- The remover's teeth will engage the stripped screw, allowing it to back out.
Important: Avoid excessive speed or force to prevent heat generation or implant thread damage.
If the screw does not rotate:
- Attach the rescue drill guide to the implant interface to ensure precise alignment.
- Use a reverse drill at 2000 rpm with copious irrigation to drill approximately 1 mm into the screw head.
- The reverse motion helps to loosen the screw by breaking the bond between screw and implant.
- Remove the drill guide carefully.
- Use the screw retrieval instrument to engage the drilled hole and attempt counterclockwise rotation.
- If manual torque is insufficient, use a torque driver for added leverage.
This method minimizes the risk of damaging implant threads and surrounding bone.
When specialized kits are unavailable or unsuccessful:
- Use a quarter round bur or a small carbide bur to carefully create a flat slot across the diameter of the screw head.
- Ensure the slot is deep and wide enough to fit a flathead screwdriver.
- Insert a flathead screwdriver or flat tip driver into the slot.
- Apply steady counterclockwise torque to unscrew the abutment screw.
This technique requires precision to avoid damaging the implant platform.
If the screw has fractured inside the implant:
- Insert a guide tube into the implant to center the drill.
- Use a screw removal drill at low speed (under 80 rpm) with irrigation to drill into the fragment.
- After loosening, use a screw removal tip to grip and rotate the fragment counterclockwise.
- Once removed, inspect the implant threads for damage.
- Use a thread repair tap if necessary before placing a new screw.
- Use copious irrigation during drilling to prevent thermal damage to bone and implant.
- Avoid excessive force to protect implant threads and surrounding bone.
- Use magnification loupes and proper lighting for precision.
- Clean implant threads thoroughly after screw removal to remove debris.
- Inspect for thread damage and use thread repair tools if necessary.
- Always replace removed screws with new Nobel Active abutment screws to ensure proper fit and torque.
- Document the procedure for patient records and future reference.
After successful removal of the stripped screw:
- Inspect the implant interface with magnification for any damage.
- Clean the implant internal threads with an ultrasonic scaler or appropriate cleaning tools.
- Use a thread repair tap if any thread damage is detected.
- Select a new Nobel Active abutment screw matching the implant platform.
- Torque the new screw according to Nobel Biocare's recommended values (usually 35 Ncm for Nobel Active).
- Monitor the implant site for signs of inflammation or complications.
Removing a stripped Nobel Active abutment screw is a complex but manageable procedure when approached methodically. Starting with conservative attempts using compatible drivers and progressing to specialized screw removal kits and advanced drilling techniques ensures the best outcome. Protecting the implant threads and surrounding bone is paramount during removal. With the right tools, adequate training, and patience, dental professionals can safely retrieve stripped screws, preserve implant integrity, and maintain successful prosthetic restorations.
Stripping typically results from over-tightening, cross-threading, corrosion, debris obstruction, or using incompatible tools, which damage the screw head or threads.
Sometimes, yes. Creating a slot on the screw head with a small bur and using a flathead screwdriver can work. However, specialized kits are safer and more reliable.
Choose the remover based on the implant platform size—Narrow Platform (NP) or Regular Platform (RP). The tools are usually laser-marked for compatibility.
Use a rescue drill guide and reverse drill to create a hole in the fragment, then use a screw retrieval instrument to back it out. This method minimizes implant damage.
Use a thread repair tap designed for Nobel Biocare implants. Carefully re-tap the threads before placing a new screw to ensure proper fit and torque.
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