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Forum Category: Implantology

Moderated by:
TheNEXTDDS Admin

Removing a Broken Implant Abutment

Dental implants are a proven treatment alternative for fully or partially edentulous patients.[1,2] Their osseointegration is a well-established process,[3,4] and implants can often eliminate the need for fixed or removable dentures entirely. While dental implants can be predictably delivered, successfully restored, and provide long-term function to today's edentulous patients, there may be times when their abutments break or require replacement for other reasons. Retrieving a partially or fully broken implant abutment can be a challenging proposition for a dental professional. As such, we have assembled some “best practices” to keep in mind when pursuing this clinical objective:
  • Proper visualization is key, as a clear field of vision can help prevent accidental damage to the implant. Be sure to use as much magnification and light as you have available. Dental loupes are a great tool for this procedure. Click here for recommendations about purchasing the right dental loupes.
  • Evaluate the site to determine if part of the implant abutment is still in place. If this is the case, you may be able to simply grasp the remaining piece and remove it with forceps.
  • If you have an ultrasonic available, try using it to loosen the broken piece through vibration. Take care to use the ultrasonic on the abutment, not on the implant itself.
  • If the vibration does not work, try knocking the abutment loose by taking the largest football bur you can fit inside the implant and, without touching the implant’s surface, “bip” your rheostat.
  • If all else fails, you may be forced to place two grooves on the internal surface of the abutment and physically break it out using a screwdriver or other such tool.
A final consideration to keep in mind is that these delicate and oftentimes complicated procedures may take a extensive chairtime to resolve. Be sure to allocate enough time between cases to fully remove the broken abutment. In some cases, you might be able to remove it quickly, but these cases have been known to take more than an hour and a half depending on the severity of the break and the stability of the abutment.
 
References:
  1. Buser D, Mericske-Stern R, Bernard JP, et al. Long-term evaluation of non-submerged ITI implants. Part I: 8-year life table analysis of a prospective multi-center study with 2359 implants. Clin Oral Implants Res 1997;8:161-172
  2. Lazzara R, Siddiqui AA, Binon P, et al. Retrospective multicenter analysis of 3i endosseous dental implants placed over a five year period. CLin Oral Implants Res 1996;7:73-83
  3. Branemark PI, Hansson BO, Adell R, et al. Osseointegrated implants in the treatment of the edentulous jaw. Experience from a ten-year period. Scand J Plast Reconstr Surg 1977;16(Supl):1-32
  4. Adell R, Lekholm U, Rockler B, et al. A 15-year study of osseointegrated implants in the treatment of the edentulous jaw. Int J Oral Surg 1981;10:387-416
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Comments

Removing a Broken Implant Abutment

09:36 AM | Mar 14,2017
This is a great topic ! Implants are now a regular topic of conversation for patients and the dental community. Even if you do not place implants, practitioners need to be able to restore and troubleshoot any issues that occur with implants. In dental school I have restore an implant and I am currently working on a treatment plan for a loose implant abutment. With more implants being placed, there's an increased need to be able to deal with problems that ay arise with implants.

Removing a Broken Implant Abutment

09:32 AM | May 12,2016
This is an excellent article for dental students! In my limited experience, I have not had to troubleshoot a failing implant. In dental school, no one teaches you how to fix a failing implant. These are very practical options that a general dentist could do to help this patient. Thanks for your article!

Removing a Broken Implant Abutment

10:35 PM | Sep 30,2014
I think this is an excellent topic to discuss not only as oral healthcare providers but as dental students. During my undergraduate career, I have had the opportunity to watch implants being placed and restore some of these implants myself. Prior to the placement of these implants, we review with the patient the possibility of implant failure due to the lack of osseointegration. However, we do not often discuss with the patient the possibility of a broken abutment. I think the retrieval of a broken abutment is a valuable skill to learn as implants are becoming increasingly more prominent in the dental field. As a future healthcare provider, I think it is necessary to review the risks of an abutment breaking with my patient early on and to discuss options if such a problem does occur. I think it is also important to recognize that if you are dealing with a patient who has an implant retained over denture, there may be two abutments involved and the time necessary to retrieve two separate abutments may be even more extensive. I also think it is important to explain to the patient the results of removing a broken abutment. Possible damage to the implant itself may occur and I think these are all risks which should be carefully discussed with the patient and that this conversation should be clearly documented.