Patient presented with dislodged abutment and crown: what implant is this?

Last Updated: Jun 05, 2014

I have a new patient who presented with a dislodged abutment and crown from an implant in #30 site [mandibular right first molar; 46]. Can anyone identify this implant? What abutment and screw can I use? What Torque? Best way to manage this case?
(Note: I did look this up on whatimplantisthat.com, but the search was not definitive. The implant that look closest was: Restore RD, Size: 4 x 13mm, Reference Number: RS4013K).

![]Crown](https://osseonews.nyc3.cdn.digitaloceanspaces.com/wp-content/uploads/2014/06/cell-010-e1401974634438.jpg)Crown
![]Strange it doesn't have threads. Was this the lab screw?](https://osseonews.nyc3.cdn.digitaloceanspaces.com/wp-content/uploads/2014/06/cell-004-e1401974655351.jpg)Strange it doesn’t have threads. Was this the lab screw?
![]External hex ](https://osseonews.nyc3.cdn.digitaloceanspaces.com/wp-content/uploads/2014/06/cell-006-e1401974678111.jpg)External hex
![]Ini Meeni MIni Mo Which scre to use the one closest to the crown is the one in the crown](https://osseonews.nyc3.cdn.digitaloceanspaces.com/wp-content/uploads/2014/06/004-e1401974714509.jpg)Ini Meeni MIni Mo Which screw to use, the one closest to the crown is the one in the crown
![]External hex](https://osseonews.nyc3.cdn.digitaloceanspaces.com/wp-content/uploads/2014/06/R22-e1401974695768.jpg)External hex

9 Comments on Patient presented with dislodged abutment and crown: what implant is this?

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doktorfirdaus

06/06/2014

Looks to me like a Branemark Implant. The screw may have broken off leaving the head but no threads

r.mirmooji

06/07/2014

Looks like a 3i,external hex. There is a site which provides radiographic templates, for different implants whatimplantisthat.com.

Carlos Boudet, DDS

06/07/2014

Restore was made by Lifecore, now Keystone. It was an external hex implant similar to the original Branemark. Try to get the information from the patient about the dentist that placed and/or restored the implant, that way you can't go wrong. If unsuccessful, then go for a trialand error with a screw for a regular diameter external hex implant. You may be able to get one from a prosthodontist friend if it is not in your "legacy implant" prosthetic parts stock. The screw you show is probably a lab screw that was used instead of the final prosthetic screw. Good luck!

CRS

06/09/2014

I agree, why was a lab screw used? The history on the restoration is always enlightening and perhaps can be used to prevent a repeat problem. If it were me I'd try to find out from the dentist who originally restored. Good luck please post how you rectified the situation.

Mark Montana

06/10/2014

3i lab screw for ex hex. Why was it used? Either the dentist didn't know the difference or lost the correct screw and tried to substitute. This screw was designed to engage minimally so we could try things in/out quickly, with two turns, it was never designed for anything else.

Randy

06/17/2014

Has anyone else noticed the "designed for peri-implantitis" emergence profile on this restoration? Please don't repeat the previous dentist's mistake when the implant is restored.

Gregori Kurtzman, DDS, MA

06/17/2014

agree with the others comments this is a Branemark ext hex implant so would contact Nobel for a new screw. I would not just pick a screw because it might fit unless you know its for a branemark or nobel ext hex implant because the thread pattern and screw seat may not match what you have

Carlos Boudet, DDS DICOI

06/18/2014

Without verification from the surgeon that this is an original Branemark external hex, you are still only guessing which manufacturer of many that cloned the original design, and using a Nobel Biocare screw would be as much a guess as any other popular clone screw. By the way, because of convenience and excellent parts availability, Nobel would be my first choice also.

Dr B

08/06/2014

I dont know if its just me, but i am unable to see the access hole on the crown. Can you confirm that there is an access hole there occlusally..? Because it could very well be that some lab technician had a sudden brainwave and decided to fabricate a crown that can be tapped in - a la bicon. :) (Maybe thats why there is a lab screw under the crown). Pls keep us posted on how you manage to restore this case. Dr B

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