Removing a Cemented Bridge without Destroying the Implants?

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Dr. G. asks:
I recently cemented a 3-unit bridge on #20-18 replacing #19 with a pontic. I need to remove the bridge to send it back to the lab for a correction. I am reluctant to attempt to remove it with a hydraulic hammer or hook. I am afraid this may either fracture the dental implant or abutment or pull the implant our of the bone. Does anybody have a technique for getting off a cemented bridge without destroying it or the implants?

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8 Responses to “ Removing a Cemented Bridge without Destroying the Implants? ”

• SFOMS June 10th, 2008

  
  

  Dr. G.,

  Obviously, this is one major disadvantage of cementing a restoration, there is no easy way of retrieving the prosthesis safely. You can drill thru the occlusal and find the abutment screws (if your abutments do have screws) to back out, leaving the abutments in the crown and screwing them back in and covering the holes with resin/composite. Otherwise, you may have to sacrifice your restoration.

• Dutchy June 10th, 2008

  
  

  If you didn’t use temporary cement or implant cement like premier cement what I assume, maybe you can drill a whole through the crowns of your brigde when you use the srews for the abutments. You can unscrew your abutments with the bridge in one piece and put on the cover screws for the time your technician needs to repair the bridge. Good luck

• DrAshish June 10th, 2008

  
  

  Hi ,Drill a hole through the implants into the screw .Use X-rays to get the right orientation.A good idea would be to place a cotton pledget in the screw so that you get a drop like Pulp chamber in case yo want to revisit the area.Open up the screw and Crowns /Bridge will come out with the abutment.
  Email:info@drashish.com
  Web:www.drashish.com

• Dr. P. June 11th, 2008

  
  

  I would agree with the previous comments; try to access the abutment screws through the occlusal portion of the crowns. If you can achieve this with small access holes, you should be able to close the access holes with resin / composite. Depending upon your patient, this may not be acceptable to them in which case, you will need to have a new restoration made. If this is the case, I would take an impression of the existing bridge as it currently is in the patients mouth, section off the bridge with care not to damage the underlying abutments, take any necessary impressions/bite and fabricate a transitional restoration with luxatemp or the like using your staring impression as a stent.

• Dr S June 11th, 2008

  
  

  If you did not use temp cement ..cut it off and start again
  I for one ,would not accept damaged goods on a new bridge

  Cement retained is all I do pretty much and so temp cement is standard for the first weeks
  When every body is happy I torque the screws again and use zinc polycarboylate
  If however the abutments are long and several and retention is good I stick to temp cement

  If the bridge needs “servicing’ after a long period of time then I would tap it off like I would for a regular tooth.
  I never use resin cement for Implants

  Althoughy you could remove the bridge as described I assure you patient will not be a happy camper

• Mark Dallamora June 12th, 2008

  
  

  Another option would be to cut a slot on the palatal collars of the bridge abutments right at the interface with the collars of the fixtures. The slot should be just big enough to place “bladed ” instrument similar to a flat screw driver. All you would have to do is twist the instrument in the slot, this should apply sufficient force to crack the cement and remove the bridge. This method does’nt apply any sudden force to the implants in any way.
  If this does’nt work, then you will have to cut the bridge off. The lab would be able to restore the collar with solder.
  Good luck.

• L. Scott Brooksby,DDS, DICOI June 18th, 2008

  
  

  this is the reason that I make screw retained crowns and bridges whenever possible. It does require you to have good soldering techniques as the precision is imperative. Then if you have a problem at anytime you unscrew and fix.

  I also use dycal as my permanent cement. This is strong, yet with ultrasonics, and some gentle banging, I can usually get it off if I was forced to use a cemented restoration.

• peter Shieh June 25th, 2008

  
  

  cutting off the bridge may not be a good idea because it will nick the abutment.If temp bond was used it can be tapped out without much problem.If permanent cement was used drill through the crowns & unscrew the crowns withthe abutments as one unit, then the crowns can be separated from the abutment by heating it over a flame & when warm pull them apart with a hemostat.But ther is a chance that the porcelain may flake if the flame is too hot

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Mon September 08 2008

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