Journal of Oral Implantology August 2013 - (Page 475)
CASE REPORT
Ultrasonic Oscillations for Conservative Retrieval of a Rare
Fracture of Implant Healing Abutment
Sudhir Bhandari, MDS*
Narinder Aggarwal, BDS
Sonika Bakshi, MBA, BDS
Dental implants can be rendered useless because of complications related to implant components such as the
fracture of abutment screw and prosthetic retaining screw. Removal of such fractured fragments is therefore
deemed necessary for the sake of prosthetic restoration. This case report presents a rare incident of healing
abutment fracture and details the stepwise and probably the most conservative clinical technique using
ultrasonic oscillations for retrieval of fractured screw fragment without affecting the internal surface of the
implant. The management was based on the fact that the screw, being an inclined plane, will unthread when
subjected to continuous vibrations.
Key Words: healing abutment, screw fracture, ultrasonic oscillations
INTRODUCTION
D
espite being predictable and with a
documented high success rate, mechanical, biological, and technical
complications do occur in dental
implant–related treatments.1,2 Implant components, especially abutment screws
and prosthetic retaining screws, fracture in response
to myriad factors (alone or in combination), ranging
from fatigue due to biomechanical overload,
repeated screw loosening and tightening, improper
placement techniques, nonpassive fit or improper
use of the prosthesis, and manufacturing errors.3–8
Retrieval of fractured screws is considered
difficult and generally poses a challenge for the
clinician to remove them without damaging the
internal surface of implants. An abutment screw
fractured above the head of the implant can be
removed by holding it with hemostats. Screw
fracture within the body of implant can be retrieved
either by the use of a self-made screwdriver6 or
using the special service set available for the
Post Graduate Institute of Medical Education and Research,
Chandigarh, India.
* Corresponding author, drsudhirbhandari@yahoo.co.in
DOI: 10.1563/AAID-JOI-D-11-00126
specific implant system (IMZ TwinPlus Repair Set K
3.3, Dentsply Friadent, Mannheim, Germany).7 The
objective of these systems is to use a removal
wedge to engage the broken screw via a slot drilled
into the top surface of the broken screw and then
applying a reverse torque. Use of endodontic
instruments has also been reported to retrieve the
thread that had fractured away from the body of
the screw.8 When the fractured screw fragment is
not retrievable, the implant could be salvaged by
modifying the screw hole and fabricating a postsupported crown.9
Following is a case report describing a rare
incident of healing abutment fracture (3.4 mm/GH
2, Friadent GMBH, Mannheim, Germany) and the
utility of a piezoelectric ultrasonic scaler (EMS
Minipiezon, Electromedical Systems SA, Nyon,
Switzerland) in conservatively retrieving the fractured screw fragment.
CASE REPORT
A 64-year-old woman in good general health
sought care for a dislodged healing abutment with
respect to an implant placed in the right maxillary
second premolar for 2 days. Intraoral examination
showed that the right maxillary first and second
Journal of Oral Implantology
475
Table of Contents for the Digital Edition of Journal of Oral Implantology August 2013
Literary Responsibility—Everyone Has a Role to Play
Rehabilitation of Surgically Relocated Integrated Dental Implants With and Without Bone Morphogenesis Protein-2
Erratum
Marginal Fit of Implant-Supported All-Ceramic Zirconia Frameworks
Influence of the Implant Diameter With Different Sizes of Hexagon: Analysis by 3-Dimensional Finite Element Method
Autologous Dental Pulp Stem Cells in Regeneration of Defect Created in Canine Periodontal Tissue
Histologic and Biomechanical Evaluation of 2 Resorbable-Blasting Media Implant Surfaces at Early Implantation Times
Efficacy of Guided Bone Regeneration Using Composite Bone Graft and Resorbable Collagen Membrane in Seibert’s Class I Ridge Defects: Radiological Evaluation
Minimal Iliac Bone Harvesting in Sinus Lift Surgery
Functional Load in Oblique Bicortical Implants: Parasinusal Implants and Palatine Implants
Ultrasonic Oscillations for Conservative Retrieval of a Rare Fracture of Implant Healing Abutment
Craniofacial Implant-Retained Auricular Prosthesis: A Case Report
Gingival Conditioning in an Implant-Supported Prosthesis: A Clinical Report
An Early Loaded Implant-Supported Mandibular Complete Arch Fixed Prosthesis in a Young Completely Edentulous Patient: A Case Report
Computer Guided Surgery for Implant Placement and Dental Rehabilitation in a Patient Undergoing Sub-Total Mandibulectomy and Microvascular Free Flap Reconstruction
Guided Bone Regeneration for Socket Preservation in Molar Extraction Sites: Histomorphometric and 3D Computerized Tomography Analysis
Osseointegration of Dental Implants and Osteonecrosis of the Jaw in Patients Treated With Bisphosphonate Therapy: A Systematic Review
Review of Current Literature
Journal of Oral Implantology August 2013
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