Journal of Oral Implantology February 2013 - (Page 81)

CLINICAL A Technique to Salvage a Single Implant-Supported Fixed Dental Prosthesis Having a Nonretrievable Implant Screw Fragment Burak Yilmaz, DDS, PhD* Edwin McGlumphy, DDS, MS An implant screw fracture is one of the common problems associated with the implant components. In some situations, it may not be possible to retrieve the fractured implant screws. As a result, clinicians either remove the implant or the implant may need to be covered over with soft tissue. The salvage of an implant with a nonretrievable screw fragment may be highly beneficial to the patients. This report describes a technique to salvage an implant-supported single restoration that has a nonretrievable implant screw fragment. Key Words: implant, fractured screw INTRODUCTION D espite high survival rates of implants, biological and mechanical complications occur. A large number of mechanical complications have been reported in the literature.1 Implant screw fracture is one of the mechanical problems associated with implant components.1,2 The fractured end of an implant screw can sometimes become stuck within the internal threads of the implants, and various techniques have been presented for retrieving the screw fragment.3–5 Once the implant screw fragment is retrieved, existing restorations can be used with a new implant screw. In some situations, however, it may not be possible to retrieve the implant screw fragments, and implants are rendered useless.4,6 As a result, clinicians might choose to either remove the implant7 and replace it with a new one, which can be an expensive option, or abandon the implant and cover it with soft tissue, which may lead to compromised function, phonation, or esthetics.7 The Ohio State University, College of Dentistry, Division of Restorative and Prosthetic Dentistry, Columbus, Ohio. * Corresponding author, e-mail: yilmaz.16@osu.edu DOI: 10.1563/AAID-JOI-D-11-00051 Therefore, salvage of an implant with a nonretrievable screw fragment may be beneficial to patients. This report describes a technique to salvage an implant-supported single restoration that has a nonretrievable implant screw fragment. This technique, which involves the use of washers with a new implant screw, can be used if at least 2 internal threads of the implant are still usable. It enables clinicians to reuse the existing restoration, is time efficient, is cost-effective, and can be used with different implant systems. The approach might be helpful as a short-term solution in otherwise hopeless implant screw fracture complications. The time gained by reusing the existing crown and keeping the implant functioning can be beneficial for the patient. One of the disadvantages of this technique, however, is that it effectively shortens the depth of penetration of the fixation screw into the implant body. Preloading the screw is the most important factor in loosening. The more torque used to tighten the screw, the less likely it will come loose. Thread stresses are inversely proportional to the length of the threaded joint.8 Considering these factors, the long-term effectiveness of the use of washers is unknown. Journal of Oral Implantology 81

Table of Contents for the Digital Edition of Journal of Oral Implantology February 2013

Could the Fountain of Youth Be All in Your Bones?
Vertical Bone Augmentation With Simultaneous Implant Placement Using Particulate
Evaluation of the Bone Healing Process Utilizing Platelet-Rich Plasma Activated by Thrombin
Effect of Model Parameters on Finite Element Analysis of Micromotions in Implant Dentistry
Peri-Implant Defect Augmentation With Autogenous Bone: A Study in Beagle Dogs
Would Nitric Oxide be an Effective Marker for Earlier Stages of Peri-Implant Disease? An
The Effect of Different Surface Treatments on Cement-Retained Implant-Supported
Effect of Rotating Osteotomes on Primary Implant Stability—An In Vitro Investigation
Horizontal Augmentation Through the Ridge-Split Procedure: A Predictable Surgical
The Bis-Acryl Stent
Clinical, Histological, and Histomorphometrical Analysis of Maxillary Sinus Augmentation
A Technique to Salvage a Single Implant-Supported Fixed Dental Prosthesis Having a
Ridge Expansion and Immediate Placement With Piezosurgery and Screw Expanders in
Pterygoid Implants for Maxillofacial Rehabilitation of a Patient With a Bilateral Maxillectomy
Technology in Maxillary Premolar Region: A New Strategy for Soft Tissue Management
Fracture of Anterior Iliac Crest Following Bone Graft Harvest in an Anorexic Patient: Case
A Technique for Constructing a New Maxillary Overdenture to a Nonretrievable Implant
Edentulous Maxillary Arch Fixed Implant Rehabilitation Using a Hybrid Prosthesis Made of

Journal of Oral Implantology February 2013