Views: 222 Author: Dream Publish Time: 2025-04-23 Origin: Site
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● Understanding the Problem: Broken Nobel Abutment Screws
● Essential Tools: Nobel Abutment Screw Removal Kit
● Step-by-Step Procedure to Remove a Broken Nobel Abutment Screw
>> Step 1: Initial Assessment and Preparation
>> Step 2: Simple Removal Procedure (If Fragment is Rotatable)
>> Step 3: Advanced Removal Procedure (If Fragment is Not Rotatable)
>> Step 4: Inspect and Repair Implant Threads
>> Step 5: Final Restoration Steps
● Additional Tips and Alternative Methods
● Why Use the Nobel Abutment Screw Removal Kit?
● FAQ (Frequently Asked Questions)
>> 1. What is included in the Nobel abutment screw removal kit?
>> 2. Can the Nobel abutment screw removal kit be used on all Nobel Biocare implant types?
>> 3. What should I do if the screw fragment is not rotatable?
>> 4. How do I prevent damage to the implant threads during screw removal?
>> 5. Are there alternative methods if I don't have the Nobel abutment screw removal kit?
Removing a broken Nobel abutment screw is a critical and often delicate procedure in dental implantology. When an abutment screw fractures inside an implant, it can compromise the stability of the prosthesis and the overall success of the implant restoration. This article provides a comprehensive, step-by-step guide to safely and effectively remove a broken Nobel abutment screw using the Nobel abutment screw removal kit, along with detailed explanations, illustrative images, and video resources to enhance understanding. Whether you are a dental professional or an implant specialist, this guide will equip you with the knowledge and confidence to handle this challenging situation.
Abutment screws are small but vital components that secure the abutment to the dental implant fixture. Over time, these screws can fracture due to various reasons such as:
- Metal fatigue from repeated loading and unloading during mastication.
- Excessive occlusal forces or parafunctional habits like bruxism.
- Improper torque application during screw tightening.
- Poor prosthetic fit leading to micromovements and loosening.
- Corrosion or material defects in rare cases.
When the screw breaks, the remaining fragment inside the implant body must be removed carefully. Failure to do so can prevent proper seating of a new abutment, potentially leading to implant failure or the need for implant removal.
The Nobel abutment screw removal kit is specifically designed to address broken abutment screws in Nobel Biocare implants. This kit is a comprehensive set of instruments tailored for different implant platform sizes and connection types. The main components include:
- Abutment Screw Removers: These are designed to engage the broken screw fragment and rotate it out of the implant.
- Rescue Drill Guides: Protective guides that fit over the implant interface to prevent damage during drilling.
- Abutment Screw Retrieval Reverse Drills: Single-use spiral drills that create a pilot hole in the screw fragment to facilitate removal.
- Abutment Screw Retrieval Instruments: Tools that engage the drilled hole and allow the clinician to unscrew the fragment.
- Screw Tap Repair Tools: Used to repair damaged internal threads after screw removal to ensure proper seating of new components.
The kit is versatile and compatible with various Nobel Biocare implant systems including Branemark, Conical Connection, Tri-Lobe, and External Hex implants.
Before starting the removal process, conduct a thorough clinical and radiographic evaluation:
- Confirm the position and condition of the broken screw fragment inside the implant.
- Determine if the fragment is rotatable or firmly stuck.
- Identify the implant platform size (e.g., 3.0, NP, RP, WP, 6.0) to select the appropriate tools.
- Ensure you have the Nobel abutment screw removal kit and necessary accessories ready.
- Inform the patient about the procedure, risks, and expected outcomes.
If the broken screw fragment is loose enough to be rotated out:
1. Select the abutment screw remover corresponding to your implant platform.
2. Attach the remover to the short handle or a slow-speed handpiece set to a maximum of 50 rpm.
3. Place the remover's working end firmly onto the screw fragment.
4. Apply gentle pressure and rotate counterclockwise to engage the screw fragment's threads.
5. Continue rotating until the fragment backs out completely.
This method is minimally invasive and preserves the implant threads.
If the fragment is firmly stuck and cannot be rotated out:
1. Select the appropriate Rescue Drill Guide based on your implant's connection type and platform size.
2. Attach the drill guide securely over the implant interface using the guide handle.
3. Connect the Abutment Screw Retrieval Reverse Drill to a handpiece set in reverse mode at approximately 2000 rpm.
4. Drill carefully about 1 mm into the screw fragment, using copious irrigation and intermittent air blasts to avoid overheating.
5. After drilling, remove the drill guide carefully.
6. Choose the correct Abutment Screw Retrieval Instrument and attach it to the short handle.
7. Insert the retrieval instrument into the drilled hole and rotate counterclockwise with light pressure to unscrew the fragment.
8. If manual rotation is insufficient, use a torque driver for additional controlled force.
After successful removal of the broken screw fragment:
- Inspect the internal threads of the implant carefully using magnification.
- Test by slowly inserting a new abutment screw to check for any resistance or cross-threading.
- If thread damage is detected, use the Screw Tap Repair Tools from the kit to restore the threads.
- Select the appropriate tap size based on the implant thread specification.
- Attach the tap to the short handle and carefully repair the threads by turning clockwise with gentle pressure.
- Re-clean the implant thoroughly to remove any debris.
- Once the threads are repaired and cleaned, insert a new abutment screw.
- Torque the screw to the manufacturer's recommended value using a calibrated torque driver.
- Proceed with seating the abutment and final prosthetic restoration.
- Schedule follow-up visits to monitor implant stability and prosthesis function.
While the Nobel abutment screw removal kit is the gold standard, sometimes alternative methods may be necessary:
- Slotting the Screw Head: If the screw is stripped but not broken, a small round bur can create a slot on the screw head to allow a flat-head screwdriver to remove it.
- Using a Dental Explorer or Probe: Occasionally, a sharpened dental probe or wooden stick can be used to catch and rotate a loose fragment.
- Ultrasonic Instruments: Some clinicians use ultrasonic tips to vibrate and loosen the screw fragment.
- Referral to Specialist: If removal is too risky or unsuccessful, consider referral to an oral surgeon or implant specialist.
The Nobel abutment screw removal kit is designed to:
- Minimize trauma to the implant and surrounding bone.
- Provide precision tools for different implant platforms and connections.
- Offer a systematic approach to both simple and complex screw removal.
- Reduce chair time and improve patient comfort.
- Preserve implant longevity by avoiding unnecessary implant removal.
Removing a broken Nobel abutment screw is a complex but manageable procedure when approached systematically with the right tools and techniques. The Nobel abutment screw removal kit provides clinicians with a reliable, efficient, and minimally invasive solution tailored to various implant systems and platform sizes. By following the stepwise protocol—from initial assessment, simple removal, advanced drilling, to thread repair—dental professionals can safeguard implant integrity and restore prosthetic function successfully. Always prioritize careful handling, adequate irrigation, and thread preservation to ensure the best clinical outcomes.
The kit includes abutment screw removers for various implant platforms, rescue drill guides, reverse drills, screw retrieval instruments, and screw tap repair tools designed specifically for Nobel Biocare implants.
Yes, it is compatible with Branemark, Tri-Channel, Conical Connection, External Hex, and other Nobel Biocare implant systems.
Use the advanced procedure involving rescue drill guides and reverse drills to create a pilot hole in the fragment, then use the screw retrieval instrument to back it out carefully.
Use rescue drill guides to protect the implant interface, drill carefully with irrigation to avoid overheating, and repair threads if necessary using the screw tap repair tools included in the kit.
Yes, techniques such as carving a slot on the screw head with a bur or using a wooden stick or dental probe to grip the fragment can be attempted, but these methods carry higher risks of implant damage and should be used cautiously.
[1] https://store.nobelbiocare.com/ca/en/media/eifu/IFU1043_EN_GB_02.pdf
[2] http://removpros.dentistry.dal.ca/ewExternalFiles/%20Nobel%20Abut%20Retrievl%20Conical%20Connection.pdf
[3] https://store.nobelbiocare.com/us/en/nobelpearl-abutment-screw-retrieval-kit
[4] https://store.nobelbiocare.com/international/en/abutment-screw-retrieval-set
[5] https://www.youtube.com/watch?v=IDh-a2Wr9fI
[6] https://www.youtube.com/watch?v=f7zO0FgkqSM
[7] https://uniqa.dental/cases/removing-broken-screw-dental-implant-guide-dentists/
[8] https://www.youtube.com/watch?v=LtvwS0HuUBg
[9] https://meridian.allenpress.com/joi/article/38/2/165/6732/A-Modified-Technique-for-Removing-a-Failed
[10] https://www.perioimplantadvisory.com/clinical-tips/article/16412202/fractured-dental-implant-screw-complications-3-methods-for-screw-retrieval
[11] https://www.youtube.com/watch?v=HshtI53ByC8
[12] https://www.yagudentaltech.com/what-tools-are-included-in-a-nobel-abutment-screw-retrieval-kit.html
[13] https://www.youtube.com/watch?v=LtvwS0HuUBg
[14] https://www.eotdental.com/uploads/pdf/trefoil.pdf
[15] https://www.youtube.com/watch?v=t9Ir7MIaUAI
[16] https://www.nobelbiocare.com/en-int/rescue-instrumentation
[17] https://www.osseonews.com/screw-fractured-on-nobel-replace-implant-which-technique-should-i-use-to-retrive-the-screw/
[18] https://www.zestdent.com/locator-angled-abutment-removal-tool-nobel-rp
[19] https://store.nobelbiocare.com/international/en/kits/surgery-sets/nobelpearl-abutment-screw-retrieval-kit
[20] https://www.youtube.com/watch?v=UkWWBJYNXYQ
[21] https://www.osseoshop.com/products/screw-removal-kit-components
[22] https://www.zestdent.com/locator-angled-abutment-screw-nobel-np
[23] https://store.nobelbiocare.com/ca/en/media/eifu/IFU1043_EN_GB_02.pdf
[24] https://www.youtube.com/watch?v=MDg8br2WNps
[25] https://www.youtube.com/watch?v=oCH0ii_r3Os
[26] https://store.nobelbiocare.com/in/en/abutment-screw-retrieval-set
[27] https://www.eotdental.com/uploads/pdf/EOT_TR_PRODUCT_BOOK.pdf
[28] https://uniqa.dental/cases/removing-broken-screw-dental-implant-guide-dentists/
[29] https://www.nobelbiocare.com/en-ca/technical-support-frequently-asked-questions-faqs
[30] https://www.ddsgadget.com/mct-replacement-screw-remover-guide.html
[31] https://www.youtube.com/watch?v=BkfPZ1PUSCE
[32] http://www.aliexpress.com/w/wholesale-abutment-screw-dental-implants.html
[33] https://www.nobelbiocare.com/en-us/technical-support-frequently-asked-questions-faqs
[34] https://store.nobelbiocare.com/international/en/abutment-screw-retrieval-set
[35] https://shop.creomc.com/products/nobel-biocare-replace-3-5mm-screw
[36] https://www.eotdental.com/uploads/pdf/NobelParallel-Manual%20.pdf
[37] http://www.novodent.hr/sites/default/files/field/file/proizvod/78423a_rescue_instr_product_overview15.1_gb.pdf
[38] https://www.youtube.com/watch?v=LaKfemQDLjg
[39] https://www.youtube.com/watch?v=rJRxl504vgU
