Retrieval Of Screw Research Articles

A Conservative Technique for Fractured Implant Abutment Screw Retrieval on an Internal Connection Implant: Proof of Concept.

Broken screw removal from the implant connection is a common but challenging process. Several proposed methods and technical solutions may result in unsuccessful removal; thus, a novel, more conservative, risk-free method is proposed as a first attempt. The proposal is to use a silicon restoration holder to be twisted counterclockwise on the dried surface of the broken fragment inside the implant connection. This method, within the limitations of a minimal case series, yielded 100% results; however, despite previous attempts with less conservative techniques, this approach showed no efficacy. This article aims to promote the use of silicon restoration holders as a minimally invasive first attempt at broken screw retrieval treatment before considering other options.

A Technique for Retrieval of Screw for Missed Screw Head

Abstract Background: Orthopaedic implants are medical devices used to replace or fix bones or to replace the articulating surfaces of joints. Once fracture healing is complete, these implants may no longer serve a functional purpose and can be removed. During implant removal surgeries, surgeons may encounter various challenges, such as stripped screw heads. While several methods for addressing this issue have been previously described, this study introduces a novel technique for retrieving stripped screw heads. Methods: Between May 2021 and September 2023, 21 patients underwent implant removal surgeries where stripped screw heads were encountered intraoperatively. The technique involved cutting the screw head with a metal-cutting drill bit, which proved to be effective in facilitating retrieval. Results: All the screws with stripped screw head could be extracted using our technique. Conclusion: Compared to traditional methods, this new approach requires less specialized skill and equipment and is more cost-effective.

Retrieval of Fractured Implant Abutment Screws: A Narrative Review.

ABSTRACTObjective:Implant abutment screws can fracture due to various biomechanical factors. Improper fit of the prosthesis, inadequate seating of the abutment, occlusal interference, and manufacturing errors are some of the causes that can result in an abutment screw fracture. Retrieval of the retained fractured abutment screw is quite challenging to the clinician. The objective of this review is to provide information on various fractured abutment screw retrieval techniques reported in literature and to formulate a structured treatment protocol for the management of fractured abutment screws.Materials and Methods:An electronic search of Scopus and PubMed databases was performed for articles between January 1989 and December 2021 using the keywords “Implant screw fracture” and “screw retrieval.”Results:Most of the articles were of the opinion that abutment screw fractures occurred due to screw loosening. Both conservative approaches and the use of commercial retrieval kits have been advocated to retrieve the fractured abutment screws. Based on various review articles, an innovative novel technique to retrieve an abutment screw fractured due to excessive torque was devised in our unit.Conclusion:Although clinicians can use various techniques to remove fractured abutment screws, every effort should be made to eliminate the cause of screw fracture. Retrieval of the broken screw fragment should be done judiciously to prevent any internal damage to the implant structure.

Survival Analysis and Torque Loosening of Experimental Screw After Mechanical Performance for Micro Conical Abutment

The most common failure in implantology are due to mechanical instability. Torque loosening or fracture of the screws are the most frequent complications. Furthermore, the fractured screw retrieval is complicated and time-consuming. So, modifications in the design of implant systems are justifiable to offer a greater degree of biomechanical stability. Thus, the present study proposes to evaluate an experimental geometry for abutment screw regarding failure probability and torque loss. Twenty implant/abutments sets (e-fix, A.S. Technology - Titanium Fix) were divided into the following groups (n=10 in each group): (1) Conventional screw (Screw neck ø 1.5 mm) and (2) Experimental screw (screw neck constricted ø 1.2 mm). The abutments were tightened with a controlled torque meter device following the manufacturer’s recommendations. Mechanical cycling was carried out with a load of 50 N.cm during 5 x 10 6 cycles with a frequency of 2 Hz at a temperature of 37°C (ISO 14801). A digital torque meter was used to measure the reverse torque values of the prosthetic screw and the micro abutment screw, before and after loading. Data were statistically analyzed by One-way Anova and Tukey test (95 %). The results of the mean values of torque loss of the micro abutment screw were 58.44 % for the control group and 55.31 % for the experimental group and the mean torque loss for the prosthetic screw was 53.3 % and 61.3 % of the conventional and experimental groups, respectively. The survival probability was 100 % for both screw groups. It was concluded that experimental screw showed a similar behavior to conventional screws, showing similar reliability after fatigue life testing.

Method of the retrieval of fractured screw fragments

Background After 10-year function percentage of the implants screw fractured are increasing. It is very difficult task to remove the screw from integrated implants. Aim/Hypothesis The aim of this research- comparative estimated efficiency of methods to removal of fractured dental implant screw. Twenty screws in implant internal connections were fractured to test fragment retrieval, comparing two methods- method using ultra-sonic tools and method using special kit by reverse f Material and Methods In this study we insert 20 implants which were divided into two groups, 10 implants per group. After we made incisions on the screws, using a diamond discs, which we placed in implants. Incisors made in the coronal third (n = 3), middle third (n = 3), and the apical third (n = 4), for each group. In the first group the fragment of the screw was extracted by ultrasonic nozzles. In the second group, fragment of the screw was extracted by special sets. Results From 20 fragments of the screws only 7 (35%) were extracted, 4 fragments by ultrasonic tools, and 3 fragments by special kit for screw retrieval. 1 (5%) of the fragment was retrieved with a fracture in the coronal third of the screw, 2 (10%) fragment with a fracture in the middle third region, and 4 (20%) fragment with a fracture in the apical third region. The average time taken to remove the screw with ultrasonic instruments is 10 minutes 30 seconds, a special set is 6 minutes. Conclusion and Clinical Implications This study demonstrated that extracting the fragment of the screw is slightly more effective by ultrasonic tools. The average time spent on the method of extracting a fragment of the screw with the use of ultrasonic instruments for 4 minutes. more about the method using a special retrieval kit. According to the experimental data, than deeper the level of the fracture, the higher probability of its retrieving.

An unconventional approach for retrieval of fractured prosthetic screw: A case report

Background Implant-supported restorations can fail biologically or mechanically. Mechanical failures include crown fracture, framework fracture, screw loosening, and screw fracture. Fracture of the implant abutment screw can be a serious problem leading to implant failure. Unavailability of universal standard screw retrieval kit in market makes it difficult to retrieve the fractured screw of various implant systems.Conclusion This clinical report describes the management of an implant prosthetic screw fracture using an unconventional technique and simple armamentarium available in regular clinic setup.

In vitro evaluation of two methods for fractured screw retrieval from dental implants

The aim of the study was to compare estimated efficiency of fractured dental implant screw removal methods. Twenty screws in implant internal connections were fractured in animal model to test fragment retrieval comparing two methods: using ultrasonic tools (group 1, 10 implants) and special reverse force kit (group 2, 10 implants). Removing screws with ultra-sonic tools proved to be slightly more effective, than using specialized kit. Mean procedure time in group 1 was 4 min more than in group 2. The possibility of screw retrieval correlates with fracture level, as deeper fractured screws were the easiest ones to remove.

A risk-based decision making tree for managing fractured abutment and prosthetic screws: A systematic review

Statement of problemIn implant dentistry, a variety of techniques are used to manage fractured abutment and prosthetic screws. All of them pose various degrees of difficulty to both the clinician and patient and risk involving damage to the implants and prostheses. PurposeThe purpose of this systematic review was to classify and organize the various reported techniques for managing fractured abutment and or prosthetic screws into a risk-based, decision making tree that could be used to guide the clinician through this difficult and time-consuming clinical procedure. Material and methodsA systematic search of the PubMed/MEDLINE database for articles published before June 2016 was performed by 2 independent reviewers. Studies published in English that described a clinical technique to retrieve or manage a fractured abutment or prosthetic screws were included. Techniques were classified according to risk of irreversible damage to the implant. Low-risk techniques were defined as those involving the use of basic hand instruments and instrument modification; moderate-risk techniques were defined as those involving the use of screw retrieval kits, rotary instruments, and screw modification; and high-risk techniques were defined as those involving modification of the implant. Published techniques were then organized into a decision-making tree. ResultsA total of 35 articles were included. The reported techniques ranged from straightforward instrumentation and instrument modification to screw or implant modifications. Seven techniques were considered low risk, 17 moderate risk, and 11 high risk. ConclusionsThe proposed risk-based decision tree is a useful tool in helping clinicians choose the most appropriate strategy or sequence of strategies that offers maximum benefit to the patient while minimizing associated risks.

Pedicle screw nut loosening: potentially avoidable causes of spine instrumentation failure.

Dear Sir, Since the first successful fusion procedures in 1911 for the Pott disease, spinal surgical fixation devices have enhanced tremendous advancements in spinal surgeries with strong evidences showing that instrumented fusion produced a higher rate of fusion [1,2,3]. Although the pedicle screws are routinely used for spinal fixation, these devices can be associated with complications within a group of patients, the resulted failures may not actually be device-made failures but instead surgeon-related errors [4]. A 65-year-old man was operated for traumatic D12 fractures 6 months ago. After the surgery, everything seemed to be alright until the last month when he noticed pain in the operated region which increased with strenuous activities. There was no history of bowel and bladder disturbances recorded. General and systemic examinations were unremarkable. Motor and sensory examinations were normal. His wounds healed well and he was healthy. An X-ray check indicated the loosening of the lower left screw head (Fig. 1). Thus, the patient was being scheduled for the repositioning of the screws. The wound was re-examined and the loose nut was identified and repositioned (Fig. 2). The patient is now being followed-up and doing well. Fig. 1 X-ray dorso-lumbar spine showing asymmetry of the rods and dislodgement of the nut from screw head. Fig. 2 (A) Intraoperative images showing loosened nut lying outside the screw head. (B) Rod in the screw head after retrieval of screw. (C) Rods being pushed down into the screw head and (D) a new nut is placed into the screw head to secure the rod in place. ... Transpedicular instrumentation provides the most biomechanically rigid restraint to spinal motions in flexion, extension and torsion through segmental spinal purchase [5]. Apart from this, the pedicle screw systems require fewer instrumented segments thus are advantageous in preserving motion segments [6]. Despite these advantages, transpedicular fixations can be associated with the risks of screw loosening, screw breakage, screw/rod disconnection, pseudo-arthrosis, and nerve root injury which occurs in dural laceration and pedicle fracture during screw insertions [4,6]. Ahmed et al. [4] reported construct failures in the form of screw binding (6 cases), screw breakage (12 cases), screw/rod dislodgement (3 cases), progressive kyphosis (5 cases), disengaged screw's cup (2 cases), and broken rods (2 cases). To avoid such mechanical construct failure, it has been suggested that there should be proper applications of the rods over the screw head in a straight perpendicular angle and applications of the screw's cup in the correct mechanical manner. The use of variable-angle (poly-axial) screws can minimize the need for rod contouring thus avoiding the pre-stress load applied on the construct and reducing the early construct failure [4]. We could not identify the true occurrences and reasons for the loosening and disengagement of the screw heads. In order to avoid such a potentially preventable complication, the handling of implants is very important. When tightening the nut, withdraw from adjusting the nut, and, instead, rotate counterclockwise until the screw head loosens and produces a tuck sound. Thus, the nut is tightened with no gaps between the grooves in the screw head and the ridges.

Retrofitting a cast dowel-core on salvaged dental implants.

Dental implant screw fracture involves attempting to retrieve the screw fragment or, as an alternative, attempting to salvage the dental implant. Circumstances that do not allow for screw retrieval require a solution in which the internal configuration of the dental implant can provide for a custom direct dowel fabrication. The proposed technique is to retrofit the fabrication of a custom cast dowel-core and provisional use of a direct procedure, which provides accuracy of fit, retention, and ease of production.

Salvaging endosseous implants with fractured abutment screws.

A technique for removing a fractured abutment screw and salvaging the endosseous implant is presented. Two commercially available screw retrieval kits are described and discussed.