Dentaltown July 2021 - 52
Fig. 10
Fig. 11
Fig. 12
guide for the pilot to work through.
Before starting, the implants were thoroughly
irrigated with sodium hypochlorite
and fl ushed with copious amounts of water
to remove any debris that could inhibit the
procedure. The guide was placed on the fi rst
implant and held fi rmly with the handle
(Fig. 7, p. 50). An Aseptico implant motor
was set to 1,400 rpm in reverse mode with
30% irrigation. The pilot (Nobel Biocare,
Fig. 8, p. 50) was run through the guide
until approximately a 0.5-1 mm divot was
created in the top of the fractured segment
(Fig. 9, p. 50), and the guide made sure the
divot was made in the center of the screw
segment (Fig. 10).
Once this was completed, a handpiece
with a tap (Nobel Biocare) was set to
20 rpm in reverse without irrigation. The
tip of the instrument (Fig. 11) was placed in
Fig. 13
the divot and the rheostat was pushed. The
counterrotation of the instrument and the
left-handed threads of the tap caused the
instrument to " bite " into the metal of the
screw and rotate it in a counterclockwise
direction. Eventually, the broken segment
reached the top of the screw channel and
stuck to the instrument (Fig. 12); in other
cases, the segment can be removed with
small cotton pliers or suction.
This process was repeated for the next
three implants. It was necessary on a few of
them to drill, try to tap and then redrill in
order to remove all the segments (Fig. 13).
Once all the fractured screws were
removed, the threads were cleaned with
an appropriately sized broach from Regal
Cutting Tools (Fig. 14) and fl ushed to assure
that new Locator attachments would thread
down without issue. A fi nal fi lm was taken
Fig. 14
to make sure the screw channels were clean
and clear (Fig. 15). The patient was released
back to the referring dentist for completion
of treatment and further evaluation on the
reasons for the prosthetic failure and crestal
bone loss.
Conclusion
Although this technique is defi nitely DIY,
it is one of those instances where the stakes
are high if the screw cannot be removed or the
internal threads of the implant are damaged.
Despite all the precautions undertaken, if
there is any damage to the internal anatomy
of the implant, a post-and-corelike prosthesis
for the implant can be considered as a last
resort to restore function.5
This type of workaround to the conventional
screw-retrieval systems with
Fig. 15
52 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
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