Dental Implant Restorations: Internal Thread Complications

This happened to me once... At the moment of installing the healling abutment I couldnt, after several attempts, I introduced a simple ucla titanium screw and nothing, it went in up till the bent part of the thread. After cursing my ass off, I addressed the problem with a reamer and after maybe 10-15 mins of reaming i retried the ucla screw and it went up all the way. I was able to place the healling abutment and so on untill i dellivered the final restoration. I used a torquetite screw just to be on the safe side and it has been 7 years and untill now no problem. I know that in the past some colleagues used an anaerobic seallant and adhesive to overcome the loosening of the screws .... that is something I dont use or approve.

Yes a few times specially with CPti implants. I have solved that using a tap screw driver. It is a 3i product and its called screw removing kit. It has drills to remove fractured screws and the tap to recreate the internal thread of externally hexed implants. Torquing the abutment screw may not solve the issue,

I am curious, was the stripping even after you tried to do the 'back-out-until-it clicks' method? I had thought this is almost full proof to prevent cross threading or is this a different problem altogehter? Any comments would be appreciated, even directly to my e-mail.

It happened to me once, I was able to remove it after a full afternoon of cursing! I have removed a few for some colleagues that asked me for help with success (I got the piece in and out and was able to correct the threads). A pattern I have seen in this clinical situation have to do with angulation, each case in the posterior area (molar area, I believe, if we do not carefully align the screw at the time of insertion and we dont allow the screw to go in without resistance and tension specially in the beggining, we will increase the chances of having this situation, placing a screw is a delicate action, the pieces are designed to fit, do not force it, if it doesnt go easy, you are not following the angulation of the implant and you will stress some areas of the thread system!! Do not use screws of different brands (dont get cheap) also the only time you apply force to a screw is when you apply the torque at the end. The removal is not that bad, it just takes time, patience and wisdom. I guess I have been lucky!!

I had to remove the broken threaded portion of a Straumann (ITI) abutment that was jammed into the internal threads of the implant. Straumann sent me a kit which enabled me to remove the broken screw and retap the implant in the mouth. They had me speak to a dental consultant who gave me some tips on how to do it. It solved the problem very nicely.

My dental provider is having trouble screwing the healing abutment. The screw keeps on striping. They tried to re-tap the screw twice and unsuccessful. They recommened to have both teeth attached to each other, using the good implant since they are both next to eachother. They will cement the bad implant post in to the attached tooth. Is this ok and sturdy or should I tell them that I rather have the implant redone? They said that they are trying to avoid redoing the procedure. Thank you for your help.

Is there a way to remove the broke off portion of the abutment screw easily? I did not know is Astra Tech made a screw removal kit or does anyone. THanks

The head of a Straumann screw will be stripped if you use the star shaped drivers from 3i or Nobel. Had this happen with a lab that did not have a Straumann driver and assumed that it was the same as Nobel. The Synocta abutment could not be tightened down properly to 35 newtons and I had a heck of a time backing it out due to the damage caused by the wrong driver. Check with your lab and make sure they have the tools from the Implant company you are using. As we know most instruments are not interchangable when it comes to implants.

Is morse taper connection of leone exacone and biocon a change of scene in implantology for srew based systems or we still may need screwed abutments for any specific situation..please comment

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