Clinical assessment of fractured implant abutment screws: The Bernese silicone replica technique.

Fractured implant abutment screws can be retrieved with repair or rescue devices. However, whether the screw was completely retrieved or the inner implant body was damaged may be uncertain. A silicone replica technique was recently implemented in Bern and may be the most predictable method available at the moment for clinically assessing the internal implant body. This technique is straightforward and precise and may help dentists determine the internal implant condition when managing a fractured screw.

Technique to retrieve implant abutment fragments.

This clinical report describes the fractured hexagonal part of an implant abutment. The initial clinical sign was a loose abutment screw. Upon further clinical evaluation, the abutment was seen to have fractured and had wedged inside the implant body. Because the implant was a bone-level internal conical connection system, access and visibility were limited. A simple and economical technique with modified round-tip scissors was used to retrieve the fractured titanium abutment.

Management of a Dental Implant with Internal Thread Damage. A Patient Treatment Report.

When a patient presents with an implant with the internal threads damaged (or cross-threaded), a definitive restorative challenge may be faced. By having a difference in hardness between an abutment screw and the implant to which it is to be attached, there is potential for internal thread damage to the implant if the opposing threads do not interface properly. As such, the operator must use care when positioning the abutment and engaging the threads to prevent possible misalignment and damage to the internal aspect of the implant body. This article describes such a situation and the action taken to overcome the problem.

Removal of a fractured locator abutment screw fragment.

BACKGROUND: Although, dental implants have been a predictable option to support several types of restorations, mechanical problems are not uncommon. Retaining and abutment screw loosenings/fractures are one of the most common technical problems. AIM: To present a step-by-step technique in order to remove a broken locater abutment screw fragment. MATERIALS AND METHODS: A 56-year-old, edentulous man with a fractured locator abutment screw in an implant was referred to our clinic from a private practice. His dentist placed a narrow platform locator abutment onto a regular platform implant and the fracture occurred. Attempts to remove the fractured fragment using a periodontal probe and a manual screw removal driver were unsuccessful. RESULTS: This clinical report presents a situation in which a fractured locater abutment screw fragment was successfully removed using an implant repair kit. CONCLUSION: A fractured locater abutment screw fragment was successfully removed using an implant repair kit including drills, drill guides and tapping instruments. To avoid similar complications, it is recommended to use appropriate manufacturer specified torque values in conjunction with compatible restorative components. CLINICAL SIGNIFICANCE: Retaining and abutment screw loosenings/fractures are one of the most common mechanical problems associated with the implant components. This clinical report showed how to remove a broken screw fragment using proper armamentarium and technique, which might help clinicians eliminate similar problems.

Modified section method for laser-welding of ill-fitting cp Ti and Ni-Cr alloy one-piece cast implant-supported frameworks.

This study aimed to verify the effect of modified section method and laser-welding on the accuracy of fit of ill-fitting commercially pure titanium (cp Ti) and Ni-Cr alloy one-piece cast frameworks. Two sets of similar implant-supported frameworks were constructed. Both groups of six 3-unit implant-supported fixed partial dentures were cast as one-piece [I: Ni-Cr (control) and II: cp Ti] and evaluated for passive fitting in an optical microscope with both screws tightened and with only one screw tightened. All frameworks were then sectioned in the diagonal axis at the pontic region (III: Ni-Cr and IV: cp Ti). Sectioned frameworks were positioned in the matrix (10-Ncm torque) and laser-welded. Passive fitting was evaluated for the second time. Data were submitted to anova and Tukey-Kramer honestly significant difference tests (P < 0.05). With both screws tightened, one-piece cp Ti group II showed significantly higher misfit values (27.57 +/- 5.06 microm) than other groups (I: 11.19 +/- 2.54 microm, III: 12.88 +/- 2.93 microm, IV: 13.77 +/- 1.51 microm) (P < 0.05). In the single-screw-tightened test, with readings on the opposite side to the tightened side, Ni-Cr cast as one-piece (I: 58.66 +/- 14.30 microm) was significantly different from cp Ti group after diagonal section (IV: 27.51 +/- 8.28 microm) (P < 0.05). On the tightened side, no significant differences were found between groups (P > 0.05). Results showed that diagonally sectioning ill-fitting cp Ti frameworks lowers misfit levels of prosthetic implant-supported frameworks and also improves passivity levels of the same frameworks when compared to one-piece cast structures.

Repairing an implant titanium milled framework using laser welding technology: a clinical report.

The application of laser welding technology allows titanium to be welded predictably and precisely to achieve accurate fit of a milled framework. Laser energy results in localized heat production, thereby reducing thermal expansion. Unlike soldering, laser energy can be directed to a small area, making it possible to laser weld close to acrylic resin or ceramic. This article describes the use of laser welding to repair an implant titanium milled fixed denture. A quick, cost-effective, accurate repair was accomplished, and the repaired framework possessed adequate strength and the same precise fit as the original framework.

Management of fractured dental implants: a case report.

An implant fracture may be one of the major causes of late implant failures. Complications, such as loosening or fracture of the prosthesis restorative components, or even fracture of the implant, may occur and dental professionals should be aware of the causes of these complications. This study reports a clinical situation involving a patient restored with a mandibular overdenture that presented a fractured implant 2 years after placement. The probable cause of the implant fracture was due to biomechanical overload caused by parafunctional habits. The implant head was flattened to make it smooth, retapping the internal screw, installing a new abutment (longer), and fabricating part of the overdenture bar. This treatment was timesaving for the patient in that the prosthesis was repaired in the shortest time possible.

Repairing ceramic restorations: final solution or alternative procedure?

This article provides an overview of dental ceramics. It addresses possible modes of failure and factors that may influence the decision to either repair or replace ceramic restorations. The authors' intention was to present ceramic repair as a reliable, low-cost, low-risk technique.

Accuracy of temporary laser welding of FPDs by Nd:YAG laser in the oral cavity.

The purpose of this study was to investigate the accuracy of temporary fixation with laser welding for fixed partial dentures (FPDs). Five kinds of experimental FPD with different welding/soldering gaps were fabricated (0, 20, 50 microm for welding; 300 microm for soldering). Then, FPDs were temporary-fixed by laser welding or with a self-curing resin. Fixation accuracy was evaluated by the change in distance and the angular deformation between two retainers. The change in distance and the angular deformation between two retainers of the FPD without welding/soldering gap were significantly larger than the other FPDs (p<0.05). With due consideration to the displacement of teeth or implants especially in the mesiodistal direction, and by taking into account the inevitable errors of the indirect method, it seemed reasonable to provide a welding space of approximately 20 microm.

O uso de microondas para polimerização de prótese total implanto-suportada submetida à carga imediata / Use of microwave for polymerization of implant-supported total prostheses submitted to the immediate load

O presente trabalho demonstra a utilização do forno de microondas para polimerização de prótese total implanto-suportada submetida à carga imediata, reduzindo o período entre a instalação dos implantes e da prótese, com resultados bastante satisfatórios e maior comodidade para o paciente.

Repair of metal-ceramic restorations using an abrasive silica-impregnating technique: two case reports.

The loss or fracture of porcelain from a crown or bridge may be viewed by patients as a dental problem in need of urgent repair. Resin-based and silica coating materials are available that demonstrate good bond strengths to metal and porcelain in the laboratory. This paper describes two cases in which a recently introduced silica coating system was used for repairing fractured metal-ceramic restorations. However, no long-term studies on the success of these materials in repairing fractured porcelain are available.

A simple method to protect patient and environment when using sandblasting for intraoral repair.

Repair or correction of intraoral restorations can be an alternative to complete replacement. A simple sandblasting device is very effective in producing a microretentive surface on every restorative material. A disadvantage of the technique is the production of an aerosol contaminated with the small, abrasive aluminum-oxide particles. In this article, a simple solution is given to protect the patient and environment against this dust during intraoral reparatory procedures involving sandblasting.

Salvaging endosseous implants with fractured abutment screws.

A technique for removing a fractured abutment screw and salvaging the endosseous implant is presented. Two commercially available screw retrieval kits are described and discussed.

Cast metal bars used for laboratory processing of bar-supported prostheses.

The procedure described uses cast metal bars in the master cast to ensure cast strength and accuracy in processing, rebasing, relining, or repairing bar-supported removable prostheses. This method has been found to be an easy way to ensure accurate processing reliability.