Incorrect management of a broken abutment screw

Abstract


 Implant abutment screw fracture is an uncommon though challenging complication. A fractured abutment screw should be removed without damaging the threads of the screw channel to reuse the prosthesis.
 
 
 To retrieve the fractured part without severing the threads, various procedures have been proposed, such as to try to unscrew the fractured part using a strong, straight and pointed probe, or to prepare a small dent into the center of the fractured part using a small round diamond burr or a fissure burr in a counter clockwise motion. Various screw removal kits have been introduced to this aim, but with inconsistent results. 
 
 
 When a physician does not manage to remove the fractured screw in either way, he/she often chooses to either replace the implant, which can be an expensive option, or abandon the implant and cover it with soft tissue, which may lead to compromised function, phonetics, or esthetics. Instead, saving the implant would great benefit patients. To this aim, the conversion of the screw chamber into a dowel space for a dowel-core and crown restoration has been proposed, thanks to the aid of laser-welded titanium for example. Instead, other techniques do not seem to have been commonly accepted. 
 
 
 The aim of the present article is to present the incorrect management of a fractured abutment screw by a classic surtex post.