title: Management of a fractured implant abutment screw: a clinical report.
abstract: In an abutment screw fracture, it is generally a challenge for the clinician to remove fractured fragments. In some cases, the screw cannot be removed, and alternative solutions should be considered. This clinical report describes the replacement of a ball attachment with a fractured screw, which was impossible to retrieve, with a cast dowel with ball attachment. The patient who presented to the Department of Prosthodontics, Yeditepe University, Faculty of Dentistry was a 65-year-old woman, wearing a mandibular complete denture supported by two implants for 4 years. She complained about the loss of retention of the denture because of the fractured abutment screw, and it was found that another dentist had previously tried to retrieve the fractured screw with no success. It was decided to construct a cast dowel with ball attachment to improve retention without sacrificing the implant. The interior of the implant and the fractured screw were machined with a rotating instrument. An impression was taken with a metal strip and silicone-based materials. In the laboratory, a stone die was generated from the impression, and a custom-made cast dowel with ball attachment was constructed. It was then cemented with glass ionomer cement and connected to the denture with the direct method. The alternative procedure described in this clinical report was successful for the removal of the fractured abutment screw and use of the existing denture.
authors.affiliation: Assistant Professor, Department of Prosthodontics, Yeditepe University, Faculty of Dentistry, Istanbul, Turkey.
authors.forename: Ceyhun
authors.initials: C
authors.lastname: Canpolat
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Ozkurt-Kayahan
authors.forename: Ender
authors.initials: E
authors.lastname: Kazazoğlu
mesh_terms: D000368:Aged; D002484:Cementation / Q000379:methods; D002858:Chromium Alloys / Q000737:chemistry; D000044:Dental Abutments; D003735:Dental Casting Technique; D059605:Dental Implant-Abutment Design; D019094:Dental Prosthesis, Implant-Supported; D019232:Dental Restoration Failure; D003781:Denture Retention / Q000295:instrumentation; D003826:Denture, Complete, Lower; D003828:Denture, Overlay; D005260:Female; D005500:Follow-Up Studies; D005899:Glass Ionomer Cements / Q000737:chemistry; D006801:Humans; D011176:Post and Core Technique
chemical_list: D002858:Chromium Alloys; D005899:Glass Ionomer Cements
keywords: Implant; complication; management; screw fracture