J Prosthet Dent 2011;105:137-138)
Lev Kandov, DDS
Complications
 Type of Complications With Implants
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Surgical
Bone loss
Peri-implant soft tissue complications
Mechanical complications
Esthetic/phonetic complications
 Why implant components break
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3
Fatigue from biomechanical overload
Improper placement techniques
Non-passive fit of the suprastructures
Manufacturing errors
Screw Removal Technique
 If the screw emerges from the implant, a hemostat can be used
for fractured screw removal.
 If the screws are fractured within the internal threads of the
implant
 A fragment removal instrument is used to retrieve a screw
fragment - Fragment Fork by Astra Tech
 Stainless steel instrument – has a sharp, fork-shaped tip and long
shank, which are used in a slow-speed handpiece
 Time-efficient, cost effective, and can be used with different
implant systems.
 The instrument has 2 different diameters (1 mm and 1.4 mm)
Procedure
1.
2.
3.
4.
5.
Flush the implant screw hole with an air/water spray, and dry the hole with air for
better access and visibility. Evaluate whether the implant threads are damaged.
Place the appropriately sized fragment removal instrument in the slow-speed
handpiece. Locate the exposed surface of the fragment in the screw hole and
center the instrument on the fragment.
Apply force to the exposed surface of the fragment with the tip of the instrument
to ensure that it is engaged with the fragment.
Once the tip of the instrument is engaged with the exposed surface of the
fragment, apply reverse torque on the fragment. Work at a slow speed so that the
tip of the instrument does not spin on the exposed surface of the fragment, and
does not damage the implant threads as the handpiece is activated.
After the instrument is engaged with the fragment, little force will be required to
retrieve the fragment, provided that the threads have not been damaged previously
1.0mm - Ref No: 22122
1.4mm - Ref No: 22632