Unknown implant: suggestions to remove attachment?

I have a new patient and she said that she had these implants placed in 2003 and said she thought they were Zimmer, but not 100% sure. I would like to use Locator overdenture attachments to increase the retention. I tried to unscrew the attachments from the implants but my 1.2 hex driver wouldn’t even fit to the screw hole on the top of the attachment. Any suggestions on to how remove the attachments? Maybe use my piezo with counterclockwise rotation? Is this is a Zimmer implant?

19 thoughts on “Unknown implant: suggestions to remove attachment?

  1. implant guy says:

    call implant direct and speak to Attachments International tech department. They will identify, and give you options for tools.

    implant rep

  2. Mark DiBona says:

    They look like you can grab them with a flat beak ortho pliers. A large hemostat might also work. There is no rule saying you have to use an internal wrench.

  3. Montana says:

    Sycone is a friction fit concept, so you don’t want to damage the exterior of the abutment by using pliers; get the proper driver.

  4. Hector Norero says:

    The implants are Ankylos..the abutment are Syncone.
    You must un screw each abutment ,and remember are Morse cone….you must release the lock nocking fron one side to othernuntil it loose

  5. mjsdds says:

    The abutments are then screwed into the implants using the 1.0 mm hexagon screwdriver. The torque- wrench with hex insert or a torque- controlled contra-angle handpiece serve this purpose.
    The recommended torque for the straining screw is 15 Ncm.

  6. Felipe Toro says:

    Ankylos implants with syncone abutments. Morse taper connection. No torque on those.
    Very unpredictable system!
    Good idea to change for locators !!

  7. Eric Adrian says:

    Those are Locator overdenture attachments made by Zest, they have a unique driver you can buy and use in ant latch torque wrench. The parts in the denture are the retentive elements that easily come out with the special removl tool.

    • Eric says:

      Those are NOT Locator attachments, they are Syncone attachments on Ankylos implants.
      The Locator attachments you may be referring to are Zest Locator F-Tx.
      These are a new fixed attachment system by Zest, only removed by the doctor, not the patient. These may work in this situation also, but if it is a fixed situation, in my opinion, you will still need metal reinforcement (span is too long between implants for acrylic to hold up under function if opposing natural teeth and it cracked already). I’ll still go back to why would you change the attachments in this case?

  8. Eric says:

    Excellent system. Very predictable.
    Removable, implant retained and implant supported system.
    Why do you want to remove the abutments?
    Appears as if the denture cracked.
    Only problem in my opinion is planning.
    I use metal reinforcement on these, works like a charm.
    Trying to figure out how to restore this system with a removable BruxZir bridge, just haven’t found the right lab yet.
    If indeed it is because the denture has a crack, I would suggest you remake denture with metal reinforcement and have lab repair current one so patient has a back up if necessary in the future.
    If opposing a removable denture, wear will be minimal over the years.
    If opposing natural dentition, will need to replace teeth every 5-7 years.
    Locators are an implant retained, tissue supported solution. If pt. was used to implant supported, they will not like Locators at all.
    Hope this helps.

  9. Mntana says:

    Per my original post, these are Ankylos Syncone, not Locators, not F-Tx. The Scone concept is implant supported and therefore a rigid prosthesis is required as well as limiting cantilever length; it will function like a fixed bridge. Recommendation is that you leave the abutments in place (the driver spec given by mjs is correct) and fabricate a new prosthesis with a metal frame (per Eric); it can be chrome-cobalt so cost will be low. Order four new Syncone caps (retentive outer contour) and pick them up intra-orally after the prosthesis is processed; this prevents distortion during processing to influence the position the caps. If done properly, this system is superior to Locators when four implants are involved; Locators work best when there is only one axis of rotation or no rotation.

  10. Implant guy says:

    Yes for the person that said those are zest locators that is not correct. Zest locators are gold in color and do not look like that at all

  11. Agim says:

    how do you take an impression of the abutments? and then get a lab analogue.
    I have a similar case where the pt. lost the denture. the gold gaps can be picked up in the denture once it is made.
    I have made several of these over the years and find they give unpredictable retention and dont do it anymore.

  12. jjk says:

    Yes I am making a new denture for this patient at this present moment. Pt had zero retention with this system even before she broke the denture. Where does the retention come from with this system? Friction? With the new caps, you think there will be more retention?

    • Felipe Toro says:

      The concept behind the syncone abutments and the integrated bar is very interesting, but clinically is very unpredictable .
      In our practice we did use the system for 20-30 patients and all ended up with locators.
      The Ankylos implant is a great implant but not the a syncone abutments. Good luck !!!

    • Eric says:

      Retention comes from friction and the system actually gets more retentive with time.
      Many patients can remove the denture when I deliver, then they return two days later and can’t get it out. There are 3 different taper angles (4, 5 and 6 degrees), maybe the previous caps are a different taper than the abutments (ie. abutments are 4 degrees and caps are 5 or 6 degrees). That would not work. Degree is on the abutments, make sure you know exactly which degree for each abutment because the may not all be the same. Some clinicians use 6 degree in the posterior implants and 4 degree in the anterior to make it easier for the patient to remove. I believe when the system first came out, they only had 4 and 6 degree, clinicians did this protocol but were annoyed and they came out with a 5 degree taper abutment. Hope this helps.

  13. Dr Y says:

    The all acrylic overdenture shown with the crack and the four Locator housings and retentive nylon anchors will not work with these ‘tapered’ telescopic overdenture abutments.
    If another dentist made that for her recently, they did not know the abutment system the patient has in her mouth.
    The European concept of the milled telescopic overdenture abutment (male) and cast metal retentive ‘overcoping’ (female) system has been very successful but is hard to execute. European trained lab techs excel in casting and milling telescopic abutments. If done well, the removable overdenture is incredibly retentive. There is no splinted bar which improves hygiene and the notorious ‘soft tissue creep’ up and around the overdenture bar. The metal:metal wear is offset by the degree of taper at which the copings are milled. In practice, as both the male and female wear from frictional fit the retention remains consistent over the years. The concept is referred to as ‘secondary splinting’.
    So with a given arch with 4 implants (minimum) and an implant fixture level impression the right technician can modify and cast UCLA style abutments for parallelism, mill them to a specific degree of taper. Next the lab can wax and cast the female retentive overcopings for each abutment. An overdenture metal framework is also fabricated –
    it can be noble metal or simply traditional Cr-Co removable framework metal.
    At the delivery appointment of the abutments the healing caps are removed and they are torqued to place, sealed and not removed from the mouth again. The overcopings are then seated on their respective abutments chairside. The cast arch framework is seated over the abutment complex and the roughened external surface of the overcoping is ‘picked up’ in the mouth with acrylic (like ProTech or Parkell’s Acrylic Solder) to the cast metal framework. At the end of this visit a pick-up impression is made to make a ‘working model’ to take the case to completion. At the lab bench GC pattern resin dies are made to the lubricated intaglia of the female overcopings and the impression is poured in stone. A wax rim is added to the frame and attached overcopings and at the next visit jaw relation records are made to take the prosthesis to wax try-in and eventual opaquing and acrylic processing/delivery. The lab, metal and componentry bills are significant. Thus, the case fee is commensurately much higher.
    But, let me tell you – the retention is phenomenal and the patients become serious fans of your practice.
    Don’t get me wrong – I absolutely swear by the Locator system which is far less expensive to both the doctor and patient. However, some patients stretch and wear the Locator nylons too easily and become frustrated with the frequency with which they have to pay for replacement gaskets. Fortunately, this is rare, but as a Prosthodontist I run into it.
    Without exception every implant overdenture case should include a cast metal framework – maxillary or mandibular. To not incorporate this into the case begs for breakage and dissatisfied patients.
    I surgically placed Ankylos implants for awhile and I am a fan. I knew of the Syncone system but did not have occasion to use it, but it is the telescopic/Conus crown concept simplified with prefab abutments of varying angles and pre-made female overcopings. I would reach out to your local Dentsply/Ankylos rep with componentry questions if you want to work with the existing abutments.

    Go to this site and it will show you the technique for the Syncone system.

    http://www.dentsplyimplants.com/en/Digital-solutions/ATLANTIS-Abutments/~/media/D0B2FEF20FD04174ACD68B1B26AF203A.ashx

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