Removal of a Fractured Locator Abutment Screw Fragment

Abstract

Retaining and abutment screw loosenings/fractures are one of the most common mechanical problems associated with the implant components. This clinical report showed how to remove a broken screw fragment using proper armamentarium and technique, which might help clinicians eliminate similar problems.

An alternative approach for the management of fractured implant abutment screws on a mandibular implant-retained overdenture: A clinical report

“…These operate with a low-speed micromotor handpiece or a selftapping rotary instrument with reverse action, but results are inconsistent. 11 …”

“…[1][2][3]8,10 However, technical and prosthetic impediments, [8][9][10] for instance, screw loosening, screw fracture, framework fracture, and crown fracture have been seen more regularly. [11][12][13][14][15] The 5-and 10-year estimates of abutment/screw fracture rates are 2.1% and 4.1%, respectively. 16 The primary reason for screw fracture is undetected screw loosening, which can be due to a nonpassive superstructure, nonaxial biomechanical overloading, or manufacturing errors.…”

“…3,5 Nevertheless, both technical and biologic problems may be encountered. [8][9][10][11] Biologic complications such as periimplant radiolucencies, periimplantitis, and radiographic signs of loss of osseointegration are uncommon. [1][2][3]8,10 However, technical and prosthetic impediments, [8][9][10] for instance, screw loosening, screw fracture, framework fracture, and crown fracture have been seen more regularly.…”

“…9,10,15 Other causes include poor denture support, poor prosthetic fit, parafunction or occlusal interferences, inadequate or excessive screw tightening, fatigue character and yielding strength of the screw material, or inadequate seating of the abutment. [8][9][10][11]17,18 Abutment screw fracture is uncommon, ranging from 0.5% to 8%, 10 but a challenging complication due to poor visibility is related to the design of the implant-abutment connection, bone remodeling, screw joint mechanics, metal fatigue, and manufacturing defects. 11,15,16,19,20 A fractured abutment screw must be removed without damaging the threads of the screw channel to reuse the prosthesis.…”

“…[8][9][10][11]17,18 Abutment screw fracture is uncommon, ranging from 0.5% to 8%, 10 but a challenging complication due to poor visibility is related to the design of the implant-abutment connection, bone remodeling, screw joint mechanics, metal fatigue, and manufacturing defects. 11,15,16,19,20 A fractured abutment screw must be removed without damaging the threads of the screw channel to reuse the prosthesis. 15,17,18,20 Removing a fragment fractured at the junction of the screw head and shank and extending from the implant is generally easier by using a hemostat, explorer, or a sharp probe in a counterclockwise motion.…”