Implant Complication

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Alan!

Can this be put up the blog

This patient came in today with a fractured IMZ implant and a fractured abutment screw.

What would be the easiest way to remove this without damaging the adjacent implant or tooth?

Trephine or Piezo??

Gail

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It looks like even if you could remove the implant without damage to the other implant and the #9 .it would be a tight area to place another. Would it be better to leave it and redo the posterior bridge with a cantilever?

Dominic

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Gail,

Using the Nobel implant retrieval tool after removing the screw fragment (task in itself: drilling the screw away with a metal cutting bur will work). The reverse torque from the removal tool will allow you to back the implant out. The tool is not in the catalog you need to call them and ask for it . An adapter to your torque wrench may be needed too. Good luck!

David

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I would first try to grab it with a small beaked ash forceps (lower) and try to rotate and luxate out the implant, breaking the Osseointegration. If that doesn’t work, I would trough palatally with a 701L high speed. If you use a trephine, you are guarrantied to lose the buccal plate. If you use a piezeo, you will probably ruin some expensive tips. If you can break the integration and extract it, you have a chance of preserving more bone.

I have tried the tool David’s suggested, but have found it tends to split the implant lengthwise, just increasing the frustration of the procedure.

Jeff

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First question, is it suppurative or symptomatic?

If neither, I could consider leaving it alone or adjusting the coronal aspect of the implant so that it is even with the osseous crest.

Lee Sheldon

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Thank you all who had responded
Attached are the radiographs from the procedure today.
I had troughed the palatal as suggested by Jeff and luxated and inserted a
Bone level Straumann and immediately placed and provisionalized

Thanks guys

Gail

[photographs redacted?]

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Mazol Tov. Nice to see.

Chuck

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