Healing Cap Stuck on BioHorizon Implants Laser-Lok Design: Recommendations?

Dr. W. asks:
I placed 3 BioHorizon 3.5 internal Hex Laser-lok implants in #19,20,21 position. The cover caps were placed with finger pressure after rinsing the internal area of the implant. Absolutely no cross threading happened as I am always very careful about that. At the uncovering 3 months later, I could not remove the cover cap on #19. I used their .05 hex tool. Then found an allen wrench with a 2 inch handle and could not budge it. I was really cranking on it as the handle was flexing greatly. The wrenches have been seated well with no stripping. The cap is perfectly flush with tapered edges so there is nothing to grab. What can I do to loosen the cap? Drilling it out seems way too risky. Thoughts?

8 Comments on Healing Cap Stuck on BioHorizon Implants Laser-Lok Design: Recommendations?

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Dr Chan
3/5/2012
This usually happened when the cover screws were inserted with the handpiece. That's the reason I always insert the cover screws manually- just like you. Sometimes I wonder if it is necessary to tighten the cover screws and make life harder for myself later! Do not drill it out. What I would do is to take it out with an engine handpiece set at a Reverse Torque of 50 Ncm, under control. Hope it helps and good luck.
Carlos Boudet DDS
3/6/2012
No need to use the handpiece. The surgical ratchet in counterclockwise fashion will remove the cover screw. Good luck!
Jay West
3/7/2012
It worked! Thanks
Pankaj Narkhede, DDS; MDS
3/6/2012
try an ultrasoinc scaler tip moving it counterclockwise on the smooth surface of the cap. Any practicles jamming the screw will lossen and hopefully u will thank me :-)
gerald rudick
3/6/2012
Since the implant was placed subgingivally and the top of it is at the crest of the ridge, the dentist probably was trying to be minimally invasive at the uncovering stage,. It could happen that there is some bone growth up to the level of the cover cap, even a small quantity of bone, and this is preventing the cap from turning counterclockwise and lifting off. Go back in again, and be able to visualize the complete circumference of the implant......if there is some bone that has been deposited on the cover cap; then with a fine diamond or scaler tip,spoon excavator,etc, remove the tiny bit of bone causing the problem ...... I have had this happen on more than one occasion, and this illustrates the affinity that osteoblasts have to titanium, as well as the respect the dentist had to the bone when placing the implant. Gerald Rudick dds Montreal
SalesVision
3/6/2012
Agree w Gerald. There must b some bone at the connection.
Yaron Miller
3/7/2012
By definition the laser lok implant is placed supra-crestally so I doubt bone is the issue here. I agree with Carlos- just use the torque wrench in reverse. The Biohorizons finger driver strips easily and you may need to order a new one as well. Hope that helps
dr_ro
3/7/2012
This has happened to me on a Nobel Biocare implant and I had to take a carbide bur with copious water and make a slit on the "occlusal" surface of the healing cap (after making the slit, it should resemble the top of a screw that a flat head screwdriver would fit into). Then just take a curved crown splitter or any flat sturdy intraoral instrument and insert into the created slit and unscrew. You may need to place a new healing abutment, but at least there's no damage done to the implant. Hope this helps ...it worked for me.

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