Dentaltown July 2021 - 50
Fig. 4
Fig. 5
Fig. 6
be tedious. Other methods include using
an ultrasonic tip to vibrate the screw out;
cutting a groove into the top of the screw
to use a small bladed driver to turn it; and
using a " claw " -type tool to slowly rotate the
screw (Fig. 4). The key to screw removal is
getting it out without damaging the implant's
very fi ne internal threads. If these threads
are damaged, a new abutment screw will
not be able to be threaded into the implant.
A few kits and instruments on the market
these days-some generic, others sold by
specifi c implant manufacturers-can help
facilitate broken-screw removal. Most kits
consist of a reverse cutting pilot drill, which
is paired with a connection-specifi c guide
(Fig. 5). The guide fi ts like an abutment
into the internal connection of the implant
Fig. 7
and guides the pilot to drill into the center
of the screw without wandering into the
side of the implant and damaging it. This
is extremely important in the cases where
the screw has fractured off deep into the
implant and there are threads coronally to
the segment of screw.
Along with the pilot and the guides
is a reverse-threaded tap or " easy out. "
This instrument, when run in reverse, will
thread into the preparation made in the top
of the fractured screw segment. Because
the instrument is reverse-threaded, as it
turns, it will grab the screw and turn it
counterclockwise, eventually unscrewing
it completely from the implant.
In this case, the ERI implants from OCO
Biomedical have a proprietary connection
Fig. 8
Fig. 9
that is not shared by any other implant on
the market; for this reason, a drill guide
was not commercially available to fi t this
style of implant.
The referring offi ce was contacted by
phone to identify the implant diameters. I
then took corresponding OCO Biomedical
impression copings for the specifi c sizes.
After removing the placement screw, a
handpiece was used to slightly modify the
screw channel to increase the diameter:
A long-shanked surgical 557 carbide was
used to remove the internal lip inside the
coping so the pilot bur would be able to
move smoothly through it. Then the two
fl at sides were adjusted to allow a handle to
slide on for stability when drilling (Fig. 6).
Once this was fabricated, I now had a stable
50 JULY 2021 // dentaltown.com
http://www.dentaltown.com
Dentaltown July 2021
Table of Contents for the Digital Edition of Dentaltown July 2021
Dentaltown July 2021 - Intro
Dentaltown July 2021 - Cover1
Dentaltown July 2021 - Cover2
Dentaltown July 2021 - 1
Dentaltown July 2021 - 2
Dentaltown July 2021 - 3
Dentaltown July 2021 - 4
Dentaltown July 2021 - 5
Dentaltown July 2021 - 6
Dentaltown July 2021 - 7
Dentaltown July 2021 - 8
Dentaltown July 2021 - 9
Dentaltown July 2021 - 10
Dentaltown July 2021 - 11
Dentaltown July 2021 - 12
Dentaltown July 2021 - 13
Dentaltown July 2021 - 14
Dentaltown July 2021 - 15
Dentaltown July 2021 - 16
Dentaltown July 2021 - Insert_Riverside1
Dentaltown July 2021 - Insert_Riverside2
Dentaltown July 2021 - 17
Dentaltown July 2021 - 18
Dentaltown July 2021 - 19
Dentaltown July 2021 - 20
Dentaltown July 2021 - 21
Dentaltown July 2021 - 22
Dentaltown July 2021 - 23
Dentaltown July 2021 - 24
Dentaltown July 2021 - 25
Dentaltown July 2021 - 26
Dentaltown July 2021 - 27
Dentaltown July 2021 - 28
Dentaltown July 2021 - 29
Dentaltown July 2021 - 30
Dentaltown July 2021 - 31
Dentaltown July 2021 - 32
Dentaltown July 2021 - 33
Dentaltown July 2021 - 34
Dentaltown July 2021 - 35
Dentaltown July 2021 - 36
Dentaltown July 2021 - 37
Dentaltown July 2021 - 38
Dentaltown July 2021 - 39
Dentaltown July 2021 - 40
Dentaltown July 2021 - 41
Dentaltown July 2021 - 42
Dentaltown July 2021 - 43
Dentaltown July 2021 - 44
Dentaltown July 2021 - 45
Dentaltown July 2021 - 46
Dentaltown July 2021 - 47
Dentaltown July 2021 - 48
Dentaltown July 2021 - 49
Dentaltown July 2021 - 50
Dentaltown July 2021 - 51
Dentaltown July 2021 - 52
Dentaltown July 2021 - 53
Dentaltown July 2021 - 54
Dentaltown July 2021 - 55
Dentaltown July 2021 - 56
Dentaltown July 2021 - 57
Dentaltown July 2021 - 58
Dentaltown July 2021 - 59
Dentaltown July 2021 - 60
Dentaltown July 2021 - 61
Dentaltown July 2021 - 62
Dentaltown July 2021 - 63
Dentaltown July 2021 - 64
Dentaltown July 2021 - 65
Dentaltown July 2021 - 66
Dentaltown July 2021 - 67
Dentaltown July 2021 - 68
Dentaltown July 2021 - 69
Dentaltown July 2021 - 70
Dentaltown July 2021 - 71
Dentaltown July 2021 - 72
Dentaltown July 2021 - 73
Dentaltown July 2021 - 74
Dentaltown July 2021 - 75
Dentaltown July 2021 - 76
Dentaltown July 2021 - 77
Dentaltown July 2021 - 78
Dentaltown July 2021 - 79
Dentaltown July 2021 - 80
Dentaltown July 2021 - 81
Dentaltown July 2021 - 82
Dentaltown July 2021 - 83
Dentaltown July 2021 - 84
Dentaltown July 2021 - 85
Dentaltown July 2021 - 86
Dentaltown July 2021 - 87
Dentaltown July 2021 - 88
Dentaltown July 2021 - Cover3
Dentaltown July 2021 - Cover4
Dentaltown July 2021 - SI_Insert_1a
Dentaltown July 2021 - SI_Insert_1b
Dentaltown July 2021 - IAOS_Book_1
Dentaltown July 2021 - IAOS_Book_2
Dentaltown July 2021 - IAOS_Book_3
Dentaltown July 2021 - Smartbox_1
Dentaltown July 2021 - Smartbox_2
Dentaltown July 2021 - SI_Insert_1b
Dentaltown July 2021 - SI_Insert_2b
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