Options for removing fully osseointegrated implant?

A film would be helpful. If the Neo OSS remover can be threaded into the implant body it may work otherwise trephine it. Trying to give advice without seeing a film to determine what the clinical situation, bone height and quality, condition of the implant and adjacent teeth( space you have to work with) is at best inadequate. But you seem to have already drawn the conclusion that it can't be detorqued so is it possible to trephine it?

Seen it before, it happens. With no film available my best guess is to trephine it.

Just took one out today. The abutment screw had broken and we tried to do a new abutment and crown without success. The Implant was placed in Mexico and the patient didn't want to go back. I used my Piezoelectric drill after studying a 3D image, to slot remove the implant with minimal trauma and bone destruction. The implant was placed to the lingual and a trephine bur would have been a disaster. I followed the removal with a bone graph and membrane. Waiting 6 months and will place a new implant in a better location.

I have taken a few ( 10 or 12 ) fractured Implants for other Dentists and 1 of mine , no problem if the coronal part has fractured off as long as there are merely a few threads internally Neobiotech will take it out very easily .....I could post cases here but I am sure they have a website you could visit . Peter

CRS is right, without imaging it is very difficult to say (CBCT woudl be ideal). I have removed implants using trephines, detorque technique & with piezo. There is generally an easy solution for every situation but anatomy and proximity to other structures & what will be left afterwards governs your decision. I personally like to trephine if I cant detorque, which ever technique will cause the least trauma to the site and the patient (from an emotional perspective) Best of Luck.

The Neo kit is the instrument of choice as it is quick, simple and destorys no bone at all. The trephine is the worst possible instrument you can use as it destroys so much bone. Piezo is somewhere in between. I have recently taken out two separate full integrated implants for other practitioners and they were amazed at how it took longer for the area to go numb than for me to remove the implant. In my opinion there is no compromise in this situation. If you can screw a Neo kit attachment into the implant this is what should be used every time otherwise you are open to litigation for not using the best solution for the patient