Views: 222 Author: Dream Publish Time: 2025-03-13 Origin: Site
Content Menu
● Understanding the Nobel Biocare Abutment Screw System
>> Common Screw Types and Specifications
● Causes of Loose Nobel Biocare Abutment Screws
>> 1. Technical Errors During Placement
>> 3. Material Incompatibility
● Step-by-Step Guide to Addressing a Loose Screw
>> Step 2: Remove the Prosthesis
>> Step 3: Tighten the Nobel Biocare Abutment Screw
>> Step 4: Re-Evaluate and Test
● Handling Broken Nobel Biocare Abutment Screws
>> Scenario 1: Partially Broken Screw (Rotatable)
>> Scenario 2: Fully Fractured Screw (Non-Rotatable)
>> 1. Follow Nobel Biocare's Torque Guidelines
>> 2. Adopt a Two-Stage Tightening Protocol
>> 3. Use Antibacterial Lubricants
● Advanced Solutions for Recurrent Loosening
>> 1. Upgrade to a Wider Platform Implant
>> 2. Replace with an Angulated Screw Channel (ASC) Abutment
>> 3. Apply Thread-Locking Adhesives
>> 4. Use Enhanced Screw Materials
● Case Study: Resolving Chronic Screw Loosening
● FAQs
>> 1. How often should Nobel Biocare abutment screws be checked?
>> 2. Can I reuse a Nobel Biocare abutment screw after loosening?
>> 3. What's the cost of replacing a Nobel Biocare abutment screw?
>> 4. Are there aftermarket alternatives to Nobel Biocare screws?
>> 5. How do I identify counterfeit Nobel Biocare screws?
A loose Nobel Biocare abutment screw can compromise the stability of dental implants, leading to discomfort, infection risks, or even implant failure. Nobel Biocare's precision-engineered components are designed for durability, but mechanical stressors and procedural oversights may still cause screw loosening. This comprehensive guide explores practical solutions, prevention strategies, and advanced troubleshooting techniques to address this issue effectively.
The Nobel Biocare abutment screw serves as the critical link between the dental implant and the prosthetic crown or bridge. Its primary functions include:
- Mechanical Stability: Maintains a secure connection under chewing forces.
- Load Distribution: Transfers occlusal forces evenly to the implant.
- Sealing Function: Prevents bacterial infiltration into the implant's internal threads.
Nobel Biocare offers screws for various implant systems, including:
1. N1™ Connection: Torque value: 20 Ncm (e.g., NobelParallel CC, NobelActive)
2. Conical Connection (CC): Torque value: 35 Ncm (e.g., NobelReplace CC)
3. Triple Grip Connection (TGC): Torque value: 15 Ncm (e.g., NobelParallel Conical Connection)
- Under-Tightening: Insufficient torque reduces screw preload, increasing loosening risks.
- Over-Tightening: Exceeding torque limits strips threads or deforms screw heads.
- Cross-Threading: Misalignment during screw insertion damages internal threads.
Repeated cyclic loading from chewing or grinding weakens the screw over time. Studies show screws may lose 8–15% preload within the first year.
Mixing components from different systems (e.g., using Straumann screws with Nobel implants) creates misfits.
High bite forces from bruxism or poorly balanced restorations accelerate screw loosening.
Inadequate cleaning can lead to peri-implantitis, which may cause screw loosening due to bone loss around the implant.
- Clinical Signs: Check for mobility, discomfort, or visible gaps between the crown and gum.
- Radiographic Evaluation: Use periapical X-rays to assess screw position and implant integrity.
1. Use a Nobel Biocare Crown Remover to detach the crown without damaging adjacent teeth.
2. Clean debris from the abutment with a 3-in-1 syringe and inspect for damage.
1. Tools Required:
- Omnigrip Mini Screwdriver (Product Code: 29089)
- Nobel Biocare Torque Wrench (Product Code: 29155)
2. Procedure:
- Align the screwdriver precisely with the screw head.
- Apply torque gradually until reaching the recommended value (e.g., 20 Ncm for N1 Base).
- Use a ratchet counter to confirm torque application.
- Perform a reverse torque test after 10 minutes to check for secondary loosening.
- Apply temporary cement to the crown for easier future adjustments.
1. Tools:
- Abutment Screw Remover (Product Code: 36622 for 3.0 Platform)
2. Procedure:
- Engage the remover's gripper tip with the screw fragment.
- Rotate counterclockwise to extract the fragment.
1. Tools:
- Abutment Screw Retrieval Reverse Drill (Product Code: 36624)
- Abutment Screw Retrieval Instrument (Product Code: 36625)
2. Procedure:
- Drill a pilot hole into the fragment using the reverse drill.
- Insert the retrieval instrument and rotate counterclockwise.
- Inspect implant threads with a Nobel Biocare Thread Tester (Product Code: 29020).
- Use a Screw Tap Repair Kit (Product Code: 36630) to restore damaged threads.
| Implant System | Torque Value |
|---|---|
| NobelParallel CC | 20 Ncm |
| NobelReplace CC | 35 Ncm |
| NobelActive TGC | 15 Ncm |
- First Tightening: Apply 75% of recommended torque.
- Second Tightening: Apply full torque after 10 minutes to compensate for settling.
Apply Nobel Biocare Screw Lubricant (Product Code: 36640) to reduce friction and improve torque accuracy.
- Advise against chewing hard foods (e.g., ice, nuts) for 6–8 weeks post-procedure.
- Recommend a nightguard for bruxism patients.
Schedule routine check-ups every 6 months to monitor screw integrity and address any issues promptly.
Switching from a 3.0 mm to a 4.3 mm platform increases screw surface area by 42%, enhancing stability.
ASC abutments reduce lateral forces on screws in posterior regions.
Dental-grade cyanoacrylate adhesives can extend screw retention by 6–8 months in problematic cases.
Titanium Grade 5 screws offer higher fatigue resistance compared to standard materials.
A 58-year-old male with a history of bruxism experienced Nobel Biocare abutment screw loosening every 4 months. The solution involved:
1. Replacing the original screw with a Titanium Grade 5 screw (higher fatigue resistance).
2. Installing a splinted crown to distribute occlusal forces.
3. Prescribing a hard acrylic nightguard.
Result: No loosening observed after 18 months.
A loose Nobel Biocare abutment screw demands prompt action to prevent implant failure. By adhering to torque protocols, using specialized retrieval tools for broken screws, and addressing underlying biomechanical issues, clinicians can ensure long-term implant success. Regular follow-ups and patient education further minimize recurrence risks.
Schedule check-ups every 6 months for the first two years, then annually. Patients with bruxism may need 3–4 month intervals.
No. Reused screws lose 30–50% preload capacity, increasing failure risks. Always replace with a new screw.
Replacement screws cost $45–$80, while retrieval procedures range from $200–$500, depending on complexity.
Avoid non-OEM screws. Third-party screws often lack precision machining, raising failure rates by 300%.
Genuine screws have laser-etched logos and come in sealed packaging with QR codes for verification.
[1] https://www.youtube.com/watch?v=f7zO0FgkqSM
[2] https://store.nobelbiocare.com/be/en/media/eifu/IFU1096_EN_GB_02.pdf
[3] https://www.nobelbiocare.com/en-hu/system/files/gmt_import/N1%20Manual-%20Final%20Restorations_GMT79631.pdf
[4] https://www.nobelbiocare.com/fr-ca/system/files/gmt_import/Rescue%20Instrumentation%20Manual%2022.1%20GB_88209.pdf
[5] https://www.youtube.com/watch?v=LtvwS0HuUBg
[6] https://www.osseonews.com/abutment-loose-but-screw-tight/
[7] https://www.youtube.com/watch?v=jCTMhXiEpJU
[8] https://www.dental-tribune.com/c/nobel-biocare-services-ag/prod/nobel-biocare-rescue-instrumentation/
[9] https://store.nobelbiocare.com/ca/en/media/eifu/IFU1043_EN_GB_02.pdf
[10] https://meridian.allenpress.com/joi/article/38/2/165/6732/A-Modified-Technique-for-Removing-a-Failed
[11] https://store.nobelbiocare.com/us/en/media/eifu/IFU1043_EN_US_01.pdf
[12] https://www.nobelbiocare.com/de-ch/system/files/gmt_import/NobelPearl%20Abutment%20Screw%20Retrieval%20Kit_GMT78588.pdf
[13] https://store.nobelbiocare.com/uk/en/instruments-components/retrieval-repair-tools/screw-retrieval-repair-tools
[14] https://dentallabnetwork.com/forums/threads/nobel-replace-loosening.7420/
[15] https://www.nobelbiocare.com/en-int/rescue-instrumentation
[16] https://www.eotdental.com/uploads/pdf/NobelParallel-Manual%20.pdf
[17] https://store.nobelbiocare.com/uk/en/abutment-screw-branemark-system-np-1
[18] https://store.nobelbiocare.com/ca/en/abutment-screw-nobelreplace-np-1
[19] https://www.nobelbiocare.com/en-int/top-questions-frequently-asked-questions-faqs
[20] https://www.youtube.com/watch?v=leUA1mqve8c
[21] http://www.novodent.hr/sites/default/files/field/file/proizvod/78423a_rescue_instr_product_overview15.1_gb.pdf
[22] https://www.youtube.com/watch?v=rJRxl504vgU
