Wednesday, May 25, 2011

Broken Implant Screws........No Problem!!

One of the things we do here at Rigby Advanced Dental is complex dentistry.......Dr. Rigby loves a good challenge!  We regularly have patients sent to us from other practitioners in need of a helping hand.  Not to long ago an oral surgeon gave us a call and referred a patient that was having problems with some existing dental implants that were placed over 20 years ago.  After a  through work-up Dr. Rigby determined the problems present as follows;
  1. The existing "bridge" had fallen off and the patient could no longer eat food on that side.
  2. The existing screws that held the "bridge" on were fractured and still inside the implants under the soft tissue that had grown over the implants since loosing the prosthesis.
  3. The existing "bridge" was inadequate to repair and use again due to fractured porcelain and failure to use proper dental engineering principals to prevent catastrophic failure some time in the future.
  4. Determine the implant system, size and diameter to order necessary parts for restoration if the screw remnants could be removed without damaging the dental implants. 
Here a few of the initial x-rays taken;

Panorex of the patients existing broken screws. 
A close up view of the broken screws in the implants.  If you look very closely you can see the front implant screw remnant is actually broken in two pieces.......this of course was discovered upon retrieval of the fragments.

One of the biggest difficulties dentists run into when considering restoration of older dental implants is what type are they, whether or not the original parts are still made and if the implant manufacturer is still in business or who owns the rights to the system.  This is one of the reasons other practitioners often decide to refer cases to a Prosthodontist......like Dr. Rigby.......they often have specialty training and experience with older systems and, when in doubt, have the necessary contacts to get things figured out!

Luckily, Dr. Rigby was able to determine all of the above information drawing on his years of experience with dental implants and previous clinical experiences.  Dr. Rigby recommended removal of the screw fragments once the overlying soft tissue had been excised.

In true prosthodontic fashion, Dr. Rigby was able to retrieve the screw remnants on the first attempt using his large bag of tricks and a bit of luck.........Dr. Rigby often jokes that if everything goes according to plan then he knows he's living right!  Healing abutments were placed to allow the soft tissue to heal properly before a final prosthesis was fabricated.

The Healing Abutments in place.  They allow for proper soft tissue healing around the implants.



Final prosthesis adjusted and torqued to place.

Once an appropriate amount of time had passed for the soft tissue to heal a final prosthesis was completed and the patient was once again able to function normally and enjoy eating.  The final prosthesis was fabricated differently using an all gold splinted restoration allowing proper dental engineering techniques to avoid screw fracture in the future.  Upon final adjustment and seating the patient stated, "You have no idea how much this means to me.......not only did you save me money and from having to get more implants, but you actually made me feel like this was a fun experience......don't even ask me how you did that!"

If you or someone you know is having a problem with existing implants or has other concerns please do not hesitate to contact Rigby Advanced Dental for a free consultation today.

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