Fractured Implant Fixture: Best Way to Remove?

I have had to remove several implants referred after fractures near the abutment connection or because of implant position. I have used a Waterlase and surgical handpiece in each different case to remove. I find with the laser being much easier and more conservative with its ample coolant directed at the area of cutting. Try to minimally reduce the bone cutting on the mesial and distal aspect of the implant and then use a root tip elevator to lever it to one side. With the new surfaces of implants or deep threads it can really feel stuck even down to the apex of the implant! Have that graft material ready. Andrew H.F.Tsang

Dr. AF I have also removed them with the Waterlase laser and with a handpiece. The laser removal wins hands down. if the implant has enough bone around it, you can also remove it with a trephine. Ace Surgical sells a good set of trephines just for that purpose. Since maxillary bone is softer, you only need to remove enough bone until you can mobilize it. Good luck! Carlos Boudet, DDS

I used piezoelectricity in the past to remove a broken implant fixture. You can see it in youtube look for "eliminacion de implante final" good luck Dr. G

The simplest way to remove fixture is using trephine bur

best way to remove it by trephine bur under proper coolant,when bur reaches 2/3rds of th implant,try to rotate it anticlock wise with a very light force,if it rotates thn pull it. don't try to pull it forcefuly otherwise it will break at 2/3rds.and if not thn again reinsert trep. bur deeply in same direction and be prepare with bone graft. very skillful job all the best

I have used all the methods mentioned above and find all of them extremely destructive. THe least destructive in my hands is the lifting of a bone plate using either a piezotome or even better a micro-saw from Friadent. this is the least destructive as you remove the plate then you can easily remove the implant with a forceps by pulling it out of the bone toward the space you have made with the bone plate. there after you can replace the bone plate with some synthetic bone and a fair amount of the bone augmentation is already complete at the same stage. If you want you can also replace the implant and replace the bone plate over this to save treatment time for the patient. this technique is the most time and cost effective in my practice. Everything works though I prefer this only because it is the least destructive in my hands. If you would like a photo series you can email me and I will send you some pics to get an idea of what it is about on docg@mweb.co.za good luck

Have you ever tried the implante retrieval tool from Nobel Biocare? Definitely the less destructive method, cause there is no need to remove any bone at all, just the implant. Googlge it for more information an images

I have not tried this myself, but I heard some colleagues are using the electrocautery. Touching the implant for several seconds, on weekly appointments, will cause a microscopical layer of necrosis on the surrounding bone. After several appointments, the implant will get loose, and will be removable without causing so much damage and bone loss. Hope this helps