Fractured screw driver: how would you handle it?

this happened to me once on a branemark cover screw. for those of you who remember, the branemark cover screw driver is a slender square driver. i was off angle and it sheared flat off in the cover screw. I tried everything to get it out but there was like a cold weld and I couldnt vibrate or loosen it. I ended up cutting a flat slot into the cover screw and backing it out that way. It probably took me more than hour and a few minutes off of my life. to remove this you would defintiely benefit from magnification. the endodontists around me work through microscopes. they don't have the nuts and bolts know-how like dentists or implant surgeons though. My advice, make every attempt at vibrating the thing loose before cutting a l sot or some other technique. You really need magnification to do this well. good luck

Happened to me as well with a DIO driver , had to cut a slot in the cover screw and used a traditionla micro driver with a pliers to remove it . Magnification and a bit of sweat . All restored and no damage to the Implant . Being in the UK the patient threatened to sue unless I waived the charge for the crown , which I did . Hopefully those days are over here with a change in legislation. Peter

Hi Peter, I'm the OP. I'm also in the uk. Luckily I had already torqued the abutment tightly with wrench and the system I'm using also cold welds together. So I'm hoping it holds. But the only solution I can think of is cutting flat line and conventional screw driver if I can't get the fractured part out of screw head.

Hi George , that should fine as they rarely loosen but tell aptient and report the incident to the manufacturer . I fit did then can try slot but would be a challenge down and abutment . , and may have to cut the abutment . As they say do enough implants for long enough and you will have many different issues to deal with. Peter

Dear,you may refer to the implant manufacturer,most of them have what is called Repair Set. Good luck

Mahmoud, it's not a 'Repair Set', it's a screw retrieval kit. Always useful to have one of these in your armamentarium.

Hi dear This happened to me also with equinox uniti implants Ultrasonics, magnification and patience, is all that is required.It ll be done in an hour.So dont worry. All the best

Really dumb question since I don't restore is there a limit to how many times these tiny little screw drivers can be used or sterilized? I have seen the hexes wear out or become blunted and I switch them out. Just a thought, metal fatigue?

Hi George, Yes I suppose it is only Aodean who is a prolific poster when it comes to implants. This sort of thing does happen but fortunately not a lot. It is often suggested to refer these cases to an endodontist, since they have scopes but as sb OMS mentioned, they don't have the nuts and bolts or the know how to tackle these cases. The best person to deal with this is an implant/restorative dentist who also has a microscope. I often get referrals from a few implant companies to help sort out issues from their users who run into similar problems, as I have a Leica microscope. IMHO this is as a result of metal fatigue as CRS has alluded to, due to cyclical autoclaving and possibly using when the tip is still warm, resulting in metal fatigue and failure usually in the screw head that is often in the restoration! The screw retrieval kit can actually come in handy for these cases as I have on occasion used it to remove the whole driver tip that has welded into the screw head and removed the whole unit together freeing up the abutment. So useful to always have this to hand. I have some nice photos of the driver tip bent, clearly due to fatigue, with the tip inside the screw head. Hope this has answered some questions.

George , possible manufacturing flaw , does happen ( We have been making Implants since 86 and things happen ) , Barry Edwards used to bend hex Implant drivers routinely placing in those days . Peter

Ahhh...hindsight is a great teacher...I have removed a few of these "screws"...in implants that I did not place...good magnification and ultrasonics should do it. It always has for me. Since I have used BICON since 1986 I never have this problem. We did have some fractured abutment posts (2mm well)...we now have a 3mm well...much stronger! To remove the 2mm well post...we take a 330 bur ...on high speed ...with a LOT of cold irrigation...drill down through the post ...it will fracture and you can remove it and replace it with another abutment. They seem to break at about 15-20 years. Maybe you could try this with your situation. Good luck!!!

Bicon have been around since 1985.

Hi Zaki and they were previously called Stryker from when initially developed in 78 . Regards Peter

Hi Peter, Has the design changed since the Stryker days. Also what do Geoff Pullen and Clive Debenham have to do with Bicon. I went to a lecture where they were credited as influencing design of the Bicon implant?

Hi CRS , it just ages us , but my mentor and great friend still places today and he started placing in 1964 ( tremonti implants ) , made his own system in 1986 , inventing the internal hex , ( alas not patenting it ) and being one of the first to suggest angled abutments were justified making them at that time . In his office he still has , old blades , Nails etc. He like Hilt was a Dentist fighting to change the way things were done in a reasonably hostile environment , now Implants are just routine . Hi Zaki , yes it was Tom Driskell who invented in 1978 ( he was involved mechanically with the US Army I think ) and I have most of the original research from the early eighties . Clive and Geoff were involved in setting up Uk base in late 80s . After all that history , strangely my only interest is what will be doing in the future. Kind Regards Peter

I was trained by Hilt in the UK and by his protege, Ben Aghabeigi. I'm forever grateful to their teaching and guidance.