Implants placed 20 years ago: can anyone help?

Looks like an original Branemark to me: http://whatimplantisthat.com/implant/branemark-mkii-self-tapping-4 You should be able to restore that with the Nobel or 3i catalog. Their parts are interchangeable. Enjoy, Nate Farley Infodontics, LLC

Those are Nobel 3.75 external hex with a conical abutment 1mm

Nobel will likely have all the tooling you need. However, you can also obtain most anything you need from Attachments International (part of the Implant Direct Company now) at less cost. Good luck, Geoff

Female hex driver; this is typically a two-piece abutment. Examine the head of the implant after abutment removal, sometimes these early generation ex-hex implants suffered deformation resulting in elongation or widening of the implant rim. If so, you may elect to proceed but the patient should be advised that you are not restoring a factory spec structure.

Attachments international sells a tool that locks onto the hex and then use a ratchet to loosen it

Postings for identification of implants are a regular feature on any implantology chat site. It's a silly business and one that could be easily avoided if all patients were given writen details of their implants. The lawyers don't seem to have picked up on this but it's only a matter of time. In Europe the EU Medical Devices Directive requires that a statement of manufacture is available to the patient for whom any custom made appliance has been made e.g. a denture or bridge. The United Kingdom General Dental Council advice sheet on Standards on Commissioning and Manufacturing of Dental Appliances states: "You should inform patients of the existence of the statement and offer them a copy ... If the patient does not choose to take a copy of the statement, you will need to keep the statement for the lifetime of the device in case it is required at a later date ... These are legal requirements. The GDC expects you to fulfil these responsibilities and will hold you accountable for doing so" "Mass produced devices which need to be adapted to meet the specific requirements of the professional user are not considered to be custom made devices" for the purposes of the Directive, so this would appear to let implantologists off the hook with regard to giving the patient details of his/her implants, although it is mandatory to to give a statement of the crown or bridge which is sitting on the implant(s). However, I think a good lawyer would argue that while an implant is sitting in the mouth and not attached to anything it is a mass produced device, but the moment a crown or bridge is placed the implant becomes a component part of a custom made device and its details must be added to the Statement of Manufacture and given to the patient. Failure to do so makes the implantologist liable in law if a future implantologist is unable to identify the device and as a result has to subject the patient to unnecessary pain suffering and expense by removing the implant and replacing it with a new device. Quite apart from the legal aspect - in Europe at least - surely it is common sense to give all patients at the end of their treatment a statement of any implant which has been placed. If this was universal practise the game of "Guess the Implant" would become obsolete. I know these observations don't apply in this particular case. My personal practise is to provide all patients with a laminated sheet (you can buy a laminator on e-bay very cheaply) with details of the date of placement, the brand and pattern of implant, and the manufacturers contact address. Takes the receptionist about 5 minutes to print off and potentially saves the patient a lot of hassle in the future.

hi they look like nobel bicare (Branemark Implant)

I always check with Darwin at Attachments International. There are also a couple of sites that help identify implants by their characteristics. Programmatically, using process of elimination.

It is ok to look at identification of the implant and parts required, but also consider the following: External hex implants were historically more prone to screw loosening problems. Conical or universal abutments were used for screw-retained cases where limited interocclusal space is a problem. Why did this case fail? Was it occlusal overload? Carefully examine the occlusion and make a risk assesment for restoring the case. Finally inform the patient of any possible complications before you start. Good luck!

Twenty years I'm impressed!

I totally agree with the comment about providing a laminated card with info about the implant system placed. Some systems have ataper-lock attachment and uninformed practitioners try to cement these abutment/crowns.This totally compromises the seating of the loosened crown/abutment assembly

I placed a ton of these "Branemark" implants in the 90's with great success. Those are Estheticone Abutments and required an automated Torque Controller to place with tricky instrumentation. You would be in a more predictable spot if you removed the posterior implant and started over with a soup de jour.