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:
- 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
- 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
- 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
- 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