Page 63 - DP Vol 20 No 3

• Ultimately, screw was removed but it got crushed
may be due to our previous attempts of removal.
• After the retrieval of the broken part of the
abutment screw, a radiograph was taken to reconfirm
its complete removal.
• Prosthesis was placed again and patient is satisfied
since then.

DISCUSSION
The current situation highlights some of the
complexities associated with the use of implant
components. In this case, the abutment screw
fracture represents one of the rare complications
encountered. The fracture is believed to have occurred
due to the unnoticed loosening of the screw, which
was exacerbated by non-axial movements during
Fig 4: Broken burs Fig 5: Osstem ESR Screw Retrieval Kit prosthetic loading, ultimately leading to the fracture.
Other possible reasons are:
• Screw loosening can be a defect in the screw itself,
• Screw may have been over-torqued on insertion,
• The abutment may not have been fully seated when
the torque was applied to the screw, resulting in
increased stress.
• Several techniques of removal of a broken
abutment screw have been documented, such as
engaging an endodontic explorer or a straight probe
Fig 6a-b: Radiographs while attempting retrieval and ultrasonic scaler.
In the described clinical situation, the broken
All the conventional methods abutment screw could not be dislodged using
mentioned in literature for an explorer or an ultrasonic scaler tip. Despite
retrieval of broken screw were employing all conventional methods in this case, we
tried. were unable to achieve the desired outcome.
• An ultrasonic scaler tip was
then inserted into the implant CONCLUSION
and was made to engage the Implant screw breakage can occur for various reasons,
notch created. and as clinicians, we must apply our expertise along
• Care was taken not to touch the with the available tools and techniques to address
internal threads of the implant each case individually. Many implant manufacturers
with the bur. provide specialized screw retrieval systems. It is
Fig 7: Remnants of Broken screw
• The ultrasonic scaler was always advisable to use well-designed screw retrieval
started at a very low speed, and kits, such as the one provided by Osstem Implant Pvt
mechanically the tip of the scaler Ltd in the present case. n
was moved counter clockwise.
• Few burs which were available
online, surprisingly, they all broke
while attempting a retrieval.
• Ultimately, the manufacturer
of the implant company was
contacted to know if they had any
prior experience with any dentist
Fig 8: Radiograph after complete removal of or not and surprisingly, they said ABOUT THE AUTHOR
broken screw that this was reported to them for
the first time by any user. They have never encountered this query. (Prof.) Dr. Amit Bhardwaj
• After not getting the support from the concerned implant company, I contacted MDS, Ph.D, FICD,FPFA
the Osstem implant company to seek their help and they contacted their Research & Professor and Head,
Development team for providing the solution. Department of
Periodontology, Faculty
• After a few days they provided Osstem ESR Kit for screw removal which had various of Dental Sciences, SGT
drills to provide easy solution for broken screw removal. The kit was easy to use and University, Gurugram
user friendly.

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