Siddharth Priyadarshi et al 60 ijcid Various Treatment Modalities for Retrieval of Broken Abutment Screw in Implant Prosthodontics 1 Siddharth Priyadarshi, 2 Syed Mohd Yusuf, 3 Ajay Singh, 4 Shitij Srivastava, 5 Himanshu Gupta Review ARticle 1,2 Student, 3 Professor and Head, 4,5 Reader 1-5 Department of Prosthodontics, Sardar Patel Postgraduate Dental College, Lucknow, Uttar Pradesh, India Corresponding Author: Siddharth Priyadarshi, Student Department of Prosthodontics, Sardar Patel Postgraduate Dental College, Lucknow, Uttar Pradesh, India, Phone: 09453325947 e-mail: spriyadarshi140@gmail.com 10.5005/jp-journals-10004-1035 ABSTRACT Dental implants made of titanium for replacement of missing teeth are widely used because of ease of technical procedure and high success rate, but are not free of complications and may fail. Out of all the failures related to implants, prosthetic failures amounts the most. Among prosthetic failures, fracture of the prosthetic screw is very common and continues to be a problem in restorative practice and it is a great challenge to remove the fractured screw conservatively. There are various techniques and instrument kits which are available for retrieval of fractured abutment screw. However, there is a lot of ambiguity among the implantologist regarding their use and practice. This article reviews the basic instrumentation concept, stepwise procedure and other technicalities related to the same. This article also enlightens various unconventional methods which are reported in the literature. Keywords: Abutment screw retrieval, Damaged internal threads, Implant screw fracture, Implant screw loosening. How to cite this article: Priyadarshi S, Yusuf SM, Singh A, Srivastava S, Gupta H. Various Treatment Modalities for Retrieval of Broken Abutment Screw in Implant Prosthodontics. Int J Clin Implant Dent 2015;1(2):60-65. Source of support: Nil Confict of interest: None INTRODUCTION Oral implantology is an ever growing feld in the practice of general dentistry due to the simplifcation of technical procedures. Implant treatment is considered as a safe technique with high rates of success. 1 Titanium endosteal implants are widely used due to the advantages offered by their mechanical properties and excellent anchorage in the jawbone, known as ‘osseointegration.’ 2 With proper diagnosis and treatment planning, appropriate placement, adequate prosthetic design, and proper maintenance, dental implants can achieve a success rate of 97 to 99%. 3,4 The success of dental implants is based primarily on the extent of osseointegration. 5,6 Quality restorations are the requirement of an implant design and procedures of fabrication are characteristic to each implant system. During the phase of diagnosis and treatment planning, it is of utmost importance to have knowledge about the possible complications that could be associated with the treatment plan. The failure of dental implants is not only due to biological factors, such as unsuccessful osseointegration or the development of peri-implantitis, but, it may also result from technical complications. These complications are relatively rare. In contrast, prosthetic complications are not uncommon. Failures of implant-supported restorations result from technical problems and can be divided into two groups: those relating to implant components, and those relating to the prosthesis. Technical problems related to implant components include abutment screw fracture. Screw loosening, 7-9 which can lead to screw breakage, is seen infrequently in today’s dental practices but was seen more often in the earlier years of implant placement. Kitagawa et al reported that it was usually associated with the external hex prosthetic connection. 10 This challenge led other implant manufacturers to design internal connections that were more stable and would prevent the problem. 11,12 If a screw loosens, and the problem is not corrected early, it can break in one of two ways: the ‘favorable’ way or the ‘unfavorable’ way. The favorable way is when the threads are not binding, and the fragment is loose; this allows for easier retrieval. The unfavorable way is when the fragment threads bind due to deformation, structural damage, or thread locking compounds; this requires extreme care and effort for retrieval. It is easy enough for most of us to inspect the case to determine which of these situations is present. COMPLICATIONS In general, these complications can be grouped into the following fve categories: 13 • Veneering material fracture • Prosthetic screw loosening • Prosthetic screw fracture • Implant fracture • Framework fracture