Views: 222 Author: Dream Publish Time: 2025-04-15 Origin: Site
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● Understanding the Problem: Why Does a Hiossen Abutment Screw Get Stuck?
● Essential Tools: The Hiossen Abutment Screw Remover and ESR Kit
● Step-by-Step Guide to Removing a Stuck Hiossen Abutment Screw
>> 1. Initial Assessment and Preparation
>> 2. Attempt Standard Removal
>> 3. Employ the Hiossen Abutment Screw Remover (ESR Kit)
>> 4. Handling Fractured or Severely Damaged Screws
>> 5. Restoring Implant Threads
● Additional Techniques and Considerations
>> Lubrication and Penetrating Oils
● Preventive Measures to Avoid Stuck Hiossen Abutment Screws
● FAQ
>> 1. What is the Hiossen abutment screw remover and how does it work?
>> 2. Can a stuck Hiossen abutment screw be removed without damaging the implant?
>> 3. What should I do if the screw head is stripped or rounded?
>> 4. How do I restore the implant threads after screw removal?
>> 5. When should I refer a patient to a specialist for stuck screw removal?
Dental implantology has revolutionized restorative dentistry, offering patients durable and functional tooth replacements. However, complications such as a stuck or fractured abutment screw can arise, posing significant challenges for clinicians. The Hiossen abutment screw, a critical component in implant systems, may become stuck due to various mechanical or biological factors. This article provides an in-depth exploration of causes, prevention, and detailed step-by-step solutions for managing a stuck Hiossen abutment screw, with a strong focus on the use of the Hiossen abutment screw remover and related specialized tools. Visual aids and video resources are integrated to enhance comprehension and practical application.
A stuck abutment screw can result from multiple factors, often interrelated:
- Screw Head Damage: The hexagonal drive of the screw can become rounded or stripped due to improper driver use or excessive torque, making it difficult to engage the screw driver.
- Corrosion and Debris Accumulation: Over time, metal debris, biological deposits, or corrosion can accumulate inside the implant threads, causing the screw to seize.
- Over-tightening or Cross-threading: Applying excessive torque or misaligning the screw during placement can cause the threads to jam.
- Fracture or Breakage: Mechanical fatigue or trauma can cause the screw to fracture inside the implant, leaving a fragment stuck.
- Internal Thread Damage: Damage to the implant's internal threads from previous attempts or improper handling can prevent screw removal.
Understanding these causes is essential for prevention and effective management.
Hiossen has developed a specialized Easy Screw Removal (ESR) Kit designed to address stuck or fractured abutment screws with minimal implant damage. The kit includes:
- Screw Removal Drill (SR Drill): A reverse-rotating drill bit used to create a precise hole in the fractured screw fragment.
- Screw Removal Tip (SR Tip): A tool that engages the drilled hole to unscrew the fragment counterclockwise.
- Abutment Removal (AR) Tips: Designed to remove fractured abutments or screws with damaged hex heads by gripping and unscrewing.
- Re-tap Tools: Used to restore damaged internal threads after screw removal.
- Guides and Handles: Ensure precise alignment and controlled torque application during removal.
These tools are engineered to preserve the implant's integrity while facilitating screw removal.
- Visual and Radiographic Examination: Inspect the screw head for damage and use radiographs to assess the screw's position and condition.
- Patient Communication: Inform the patient about the procedure, potential risks, and expected outcomes.
- Sterile Setup: Prepare the ESR kit and ensure all instruments are sterilized.
- Use the appropriate Hiossen driver to apply gentle, steady counterclockwise torque.
- If the screw head is stripped, try alternative drivers or create a small slot on the screw head with a bur to use a flat driver.
- Align the Guide: Position the ESR guide over the implant's internal hex to ensure accurate drilling.
- Drill a Hole: Use the SR drill at 1200-1500 rpm with continuous irrigation to prevent heat damage while creating a hole in the screw fragment.
- Engage the Screw: Insert the SR tip into the guide and press down to engage the screw fragment.
- Remove the Screw: Rotate the tool counterclockwise to unscrew the fragment carefully.
- Clean the Area: Irrigate and suction to remove metal debris and ensure a clean implant surface.
- Use the Abutment Removal (AR) Tip to grip and remove fractured abutments or screws with damaged hex heads by applying gentle counterclockwise rotation and slight wiggling.
- For screws with slipped hex heads, create a small hole with a 0.8 mm round bur and use the AR tip mini to extract the screw.
- After screw removal, use the Re-tap tool with a torque wrench to restore damaged internal threads by rotating clockwise gently, then remove by rotating counterclockwise.
- Repeat until the threads are clean and ready for a new screw.
- Verify the implant is free of debris and damage.
- Insert a new abutment screw and crown.
- Schedule follow-up to monitor implant stability and patient comfort.
Ultrasonic scalers with specialized tips can sometimes help loosen stuck screws by applying vibrations that break the bond between the screw and implant threads. This method should be used cautiously to avoid implant damage.
Applying a biocompatible lubricant or penetrating oil around the screw interface can reduce friction and facilitate removal. However, ensure the lubricant is safe for intraoral use and thoroughly cleaned afterward.
- Do not apply excessive force that risks damaging the implant body.
- Avoid repeated unsuccessful attempts that can worsen thread damage.
- Always use the correct size and type of driver to prevent screw head stripping.
Prevention is always better than cure. Here are some best practices to minimize the risk of a stuck abutment screw:
- Proper Torque Application: Use a calibrated torque wrench to apply the manufacturer-recommended torque during screw placement.
- Use of Quality Components: Always use genuine Hiossen abutment screws and compatible components to ensure proper fit and function.
- Regular Maintenance: Schedule routine check-ups to inspect implant components and tighten screws if necessary.
- Avoid Over-tightening: Excessive torque can cause screw deformation or fracture.
- Careful Handling: Avoid cross-threading by aligning the screw properly before insertion.
- Immediate Attention to Looseness: Address any screw loosening promptly to prevent further complications.
- Always use copious irrigation during drilling to prevent thermal damage.
- Apply light, controlled pressure to avoid implant thread damage.
- If the screw fragment is mobile, gentle vibration or lubrication can assist removal.
- Use re-tapping tools to restore threads before placing a new screw.
- Document the procedure thoroughly for medico-legal purposes.
- Maintain a calm and methodical approach to avoid escalating the problem.
Managing a stuck Hiossen abutment screw requires a combination of careful assessment, specialized tools, and precise technique. The Hiossen abutment screw remover and ESR kit provide an effective, minimally invasive solution to this common implant complication. By following the outlined steps and best practices, clinicians can safely remove stuck screws, restore implant threads, and ensure successful implant restoration, ultimately improving patient outcomes. Prevention through proper technique and maintenance remains the best strategy to avoid such complications.
The Hiossen abutment screw remover is a specialized toolset within the ESR kit designed to remove stuck or fractured abutment screws. It uses a reverse-rotating drill to create a hole in the screw fragment and a screw removal tip to engage and unscrew the fragment counterclockwise, minimizing implant damage.
Yes, by using the ESR kit and following proper protocols such as guided drilling, irrigation, and controlled torque, the screw can be removed while preserving the implant's internal threads. Damaged threads can be restored with re-tapping tools.
If the screw head is stripped, you can create a small slot on the screw head with a bur and use a flat driver to unscrew it. Alternatively, use the AR tip from the ESR kit to engage and remove the screw.
Use the re-tap tool included in the ESR kit with a torque wrench to gently rotate clockwise and restore the threads. Remove the re-tap by rotating counterclockwise. Repeat until the threads are clean and ready for a new screw.
Refer to a specialist if the screw is severely damaged, the implant threads are extensively damaged, or if multiple removal attempts have failed. Complex cases may require advanced equipment or surgical intervention.
[1] https://hiossen.com/wp-content/uploads/2024/08/Rescue-Kits-Manual_PM23RCKLTR1.0-1.pdf
[2] https://www.youtube.com/watch?v=0jks0nrwcck
[3] https://www.linkedin.com/pulse/case-study-3i-hiossen-abutment-screw-retrieval-charles-mastrovich
[4] https://www.straumann.com/content/dam/media-center/medentika/en-us/documents/brochure/USLIT.2182-Medentika-Rescue-Kit.pdf
[5] https://www.youtube.com/watch?v=IDh-a2Wr9fI
[6] https://hiossen.com/wp-content/uploads/2024/12/Rescue-Kits_Manual_PM25RCKLTR1.0.pdf
[7] https://uniqa.dental/cases/what-to-do-if-the-screw-in-the-implant-breaks/
[8] https://uniqa.dental/cases/removing-broken-screw-dental-implant-guide-dentists/
[9] https://dentallabnetwork.com/forums/threads/screw-coming-loose-repeatedly-whats-wrong.31924/
[10] https://www.hiossenimplantcanada.ca/tag/abutment-screw/
[11] https://www.youtube.com/watch?v=YRzDG7Hu9lA
[12] https://hiossen.com/wp-content/uploads/2022/05/EFR-Kit.pdf
[13] https://eshop.hiossen.com/abutment-removal-tip-ar-tip/
[14] https://www.youtube.com/watch?v=CMf6vO0bO5Q
[15] https://www.youtube.com/watch?v=HZlxR4Yx7us
[16] https://www.hiossenimplantcanada.ca/esr-rescue-kit/
[17] https://www.reddit.com/r/Dentistry/comments/1h1x3cp/retrieving_a_broken_screw_from_an_implant_body/
[18] https://hiossen.co.id/about-us/surgical-kits/rescue-kits/esr/
[19] https://hiossen.com/products/esr-kit/
[20] https://www.youtube.com/watch?v=bzdSGcxdmt8
[21] https://www.hiossenimplantcanada.ca/osseointegrated-implant-complications-management/
[22] https://www.instagram.com/osstemuk/reel/CvPnuwLNho3/?locale=zh_CN
[23] https://www.youtube.com/watch?v=qWSi3C8cEss
[24] https://hiossen.com/wp-content/uploads/2024/01/Hiossen-Implant-System_PC24HISLTR1.0.pdf
[25] https://www.youtube.com/watch?v=Mik3D3tm2kA
[26] https://www.youtube.com/watch?v=hiqfSHFSjcs
[27] https://uniqa.dental/cases/what-to-do-if-the-screw-in-the-implant-breaks/
[28] https://www.youtube.com/watch?v=017o038ua3g
[29] https://hiossen.com/products/e-driver/
[30] https://uniqa.dental/product/screw-for-abutment-for-hiossen-conical-connection-et-system-rp/
[31] https://www.zestdent.com/locator-hiossen-et-ii-iii-sa-fixture-m-abutment
[32] https://hiossen.com/hiossen-blog/common-questions-about-dental-implants/
[33] https://hiossen.com/dental-implants/guide-to-dental-implants/
[34] https://eshop.hiossen.com/screw-removal-tip-sr-tip/
[35] https://www.dentmax.com.tr/en/treatments/hiossen-dental-mplant-stanbul-turkey
[36] https://www.osseonews.com/removal-of-fractured-implant-screws-any-ideas/
[37] https://www.zestdent.com/locator-hiossen-us-abutment
[38] https://www.straumann.com/content/dam/media-center/medentika/en-us/documents/brochure/USLIT.2182-Medentika-Rescue-Kit.pdf
[39] https://uniqa.dental/cases/removing-broken-screw-dental-implant-guide-dentists/
[40] https://www.osstem.com.hk/wp-content/uploads/2020/03/EFR-ESR-Kit-01.2015.pdf
[41] https://www.perioimplantadvisory.com/clinical-tips/article/16412202/fractured-dental-implant-screw-complications-3-methods-for-screw-retrieval
[42] https://www.linkedin.com/pulse/case-study-3i-hiossen-abutment-screw-retrieval-charles-mastrovich
[43] https://www.youtube.com/watch?v=BkfPZ1PUSCE
