How to remove cemented crowns from abutment?

Premier Implant cement or temp bond and should be able to remove easily if needed , but some types of abutment can lead to a cold seal due to angulations . Just use local and knock off , if an Implant "becomes loose " it was failing anyway ... Peter

Dr. Peter Is absolutely right. BUT, if u have cemented the crowns with permenant cement. Always take photos with intraoral camera of the abutment and the screw before cementation. Drill a hole in the crown with the photo reference until you can access the screw and remove the crown along with the abutment.

Usually when we want to cement a crown , we ask the lab to do darker point on the area of abutment axis , so it can be easier direct the implantologist during penetration .

I always used to specify a notch on the metal collar of the lingual surface of a cement retained crown. This generally made removing the crown much easier if necessary. Also, we always use temp bond. Having said that I have had occasion to slice the crown off a quite a few times and also drill through the top to access the screw (don't try this with an angled abutment though). I now only use screw retained crowns. Good luck!

I hope that when you say "implant mobility", you actually mean loose abutment. If fifty percent of your cases result in either one, you need to reevaluate your procedure steps. The most common causes of abutment loosening are related to: Improper tightening torque of abutment screw Non- passive fit of framework Excessive forces (Clenching) Occlusal imbalance such as lack of posterior support, interferences, etc... You need to look closely at these cases and try to determine what is the reason this is happening Start backwards step by step, starting with the occlusion. As far as the technique to remove cemented crowns, the safest way means perforating the crown to gain access to the abutment screw. Any other way increases the risk of damage to the implant threads. Good Luck!

As pankaj said , the safest bet would be, keep reference of where on the crown you would have the acess to the screw. Photographs and radiographs help in this. Drill a hole in the area and expose the screw head. Remove the screw , you would end up removing the crown along with the abutment. Do not try to remove the crown from the abutment, because you may end up damaging the abutment collar. Just send it to your lab and ask them to fire it once in a furnace. High temperature would burn the cement and the abutment would easily come out. Clean both in a ultrasonic cleaner and thats about it. U can start a practice of staining the approx position of the acess screw hole on the ceramic crown by instructing so to your lab. But what surprises me is why do you have to remove so many crowns. Please reheck ,Torque that are using, Occlussion that your lab is creating, Para functional habits of your patients,Fit of your restorations(Shud b Passive or you could end up fracturing your screws also, a. nd trust me thats trouble).All the best

Providing the crown is on with a soft (temporary) cement, I cut a small notch in the lingual of the crown and use a pneumatic crown remover made by Dentcorp. It really works great. It attaches to the high speed hose and uses air pressure to rapidly tap the crown. If that doesn't work, then I do what has been recommended and prep an access hole to get to the screw.

I wouldn't recommend trying to remove the crown by force in any way or shape. Whether it is with a tapper or a pneumatic tool ... If it was cemented with temporary cement try with some hemostat to gentle remove the crown. If it doesn't come off abort any attempt to retrieve the crown intact from the abutment it is just not worth the risk. Options: 1) Trim ceramic mesially and distally till you can lift the abutment and uncrew the whole unit ( Crown and abutment together) 2) Section crown and remove it You only need one case where the lip of the implant breaks or any permanent damage happen to the implant to learn a major lesson not to try and remove any crown by force. Like someone mentioned it you have a high rate of loosening so you need to re-evaluate your protocol when it comes to placing and restoring those implants. Good luck !

I would not advise banging on an osteointegrated implant that you wish to keep. The bone won't be happy. I recommend screw retention for retrievability so the implant needs to be optimally placed to allow that as a first choice. If not possible then appropriate temporary cement. When the crown needs to be cut off there is a significant possibility of damage to abutment and or implant itself. An implant is not a tooth and removing them is difficult and can lead to unpredictable bone loss. Listen to the prosthodontist above great advice.

This is pretty simple, but you are going to lose the crown. Take an preliminary impression to fabricate a temporary later. Using copious water irrigation and a high speed course diamond, slot through the crown from buccal margin around the occlusal to the lingual margin. Pry the "split" crown gently off the abutment. If necessary, remove interproximal porcelain as well. Tighten the loose abutment to achieve proper torque. Impress for a new crown as if the tooth were natural. Fabricate the temporary and place with temp cement. A word of advice: Very few cemented crowns will have the abutment loosen if the occlusion is correct and the screw is torqued to the manufacturer's specifications. It happens, but should be VERY infrequent.

though the crowns are cemented retained ones. what is the general opinion of having a access opening to the screw head through the cemented crown which can be sealed post cementation. of course this option may be limited to cases where the straight abutment is used and in palatal aspect of the anteriors