Remove Broken Screws from Screw-Vent 10mm Placed 20 Years Ago: Any Insights?

Last Updated: Jan 22, 2012

Dr. B asks:

I am an endodontist who with the use of the surgical operating microscope and our endodontic micro-instrumentation has been entrusted to remove broken screws from implant fixtures. I have removed many screws, some easily unwinding while others had to be drilled out. So far all successful. I now have been referred a patient who has a Screw-Vent 10mm implant placed around 20 years ago with the abutment fracturing 17 years ago. With word getting out that I remove these screws this patient has presented to my office. This case is different than others in that there is an internal hex that is still in place within the fixture. Since I have not been able to unwind the screw, I have initiated drilling out the screw and hex arriving at one of the internal walls. I hope to remove enough of the hex structure to be able to work the hex out and then concentrate on the screw. With talk about “cold welding” I am feeling a little discouraged. Is there anyone who has been in this position or has insight to the removal of these remaining segments?

6 Comments on Remove Broken Screws from Screw-Vent 10mm Placed 20 Years Ago: Any Insights?

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Robert Wolanski

01/24/2012

Have you contacted Dr. Niznick at implant direct? He is probably your best resource.

Alejandro Berg

01/24/2012

I believe you are in the correct path, just need to get to the opposite wall now, so you can remove it. If its to tight you can be facing a dissastrous situation, arround 20 years ago there was a tendency to use an anaerobic sealant basically it was locktite. A sort of crazyglue that was placed in the abutment base and in the screw, it polimerized in absence of oxigen and fixed everything pretty much forever. If so, you are done, there is almost no chance of getting it all out and being able to use another abutment. Best of luck

valentin

01/24/2012

Did you try ultrasonic tip ?

gerald rudick

01/24/2012

If you have succeeded in cutting off the head of the screw, and whether or not Ceka Bond or Locktite was used, there is hope. A lot also depends on the position of the implant in the mouth, good visibility, no bleeding, and easy access. Using a very small round elongated high speed bur, a hole can be drilled into the center core of the screw. There are some dental bur manufacturers that make latch type slow speed tiny round burs that cut in a counterclockwise fashion.....reverse the contrangle. Since the high speed bur cut a countersink hole in the shaft, it is easy to place the counterclockwise bur into this hole without slipping. Some heat will be generated while the slow speed bur is turning in the screw, and this heat will transfer out and soften the resin if there is any.....it should come out if the head has been totally cut off and the screw is not under tension. Gerald Rudick dds Montreal, Canada

Greg Minzenmayer

01/24/2012

Nobel Biocare has a screw retrieval kit that usually works well.

Dr.ganesh shetty

01/25/2012

Try a pointed ultrasonic scaler tip.

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