Removal of a fractured implant screw

Author Dr. Young-Ku Heo, DDS, MDS, PhD

Director of Global Academy of Osseointegration Seoul, Korea

Clinical case (Case presentation & Movie)

A 47 year old male patient was referred to the clinic for removal of a fractured implant screw.

M 2.0 Perfect guide(for Φ1.2 drill) connected to a PG driver.

Periapical view. For a perfect guide to be screwed into the screw hole, an implant has to have at least 1mm of the screw threads on top of the fractured screw.

M2.0 perfect guide(for Φ1.2mm) was tightened to 15Ncm in the screw hole. A perfect guide positions a drill the dead center of the screw and prevents it from damaging the threads of the implant.

A Φ1.0mm reverse drill is used at 2,000rpm with copious water irrigation. Drilling direction should be in reverse. (First start with small size drill)

Implant motor was turned on reverse.

Using a perfect guide, a reverse drill was placed right on top of the fractured screw. Then approximately 1.0mm was gently drilled vertically down. The use of rubber stoppers is suggested for 1.0mm of depth control.

A Φ1.0mm screw remover matching to the reverse drill is being connected to a shank driver.

The fractured screw was being removed by rotating the screw in counterclockwise direction.

The fractured screw came out of the screw hole.

Drilled site in the center of the fractured screw.

Postoperative view of screw removal.