Removing a cover screw on Nobel Biocare Replace Select implant: any ideas?

Take a high speed handpiece with a #6 round bur. Drill right into the screw access on the cover screw until the body of the cover screw disengages. Now all you have left is the extension of the cover screw inside the implant. You'll now be able to take a screwdriver and unscrew the remainder of the screw that's inside the implant. The reason you can't get it out right now is because that cover screw has created a preload with the top surface of the implant that exceeds your ability to unscrew it.

Dumb question but is there any bone over the edges of the coverscrew?

i replace the unigrip drivers every month or so. they do wear, and you will be much more prone to stripping when they do.

This is something that can happen on all dental implant systems. The source of the problem could be the blood that is left inside the implant when the cover screw was attached. The fibrin in the blood very effectively glues the two parts together. Upon inspecting several of retrievals with this phenomenon, the dried blood was always present. The best course here is to cut a slot all the way across the cover screw and lay an elevator in the slot like a breaker bar and back the screw off. Either the screw will loosen or the implant will come out, but at this point this is probably all you can do.

What does tech support at Nobel suggest? Could the screw be cold welded due to stripped threads? And honestly fibrin can't glue metal parts together, but dried blood, bone or any debris could wedge in these very delicate threads to affect seating of the screw. The one time I could not remove a screw after being sure the implant margins were Clear of soft tissue or bone, the implant came out since it was not osteo integrated! So I started over! The implant screw drivers are very delicate and easily stripped so like sb oms I switch them out when worn. Good Luck!

Try ultrasonics to back it up. May take a while but its safe

Do not panic. Try a gouge on the outside of the screw. It never fails. Tell me if you've done well my idea.

use an ultrasonic tool to vibrate the screw and try again

Hope it comes out. I try to irrigate thoroughly so no blood contamination is there before healing screw is placed. And I place a small amount of antibiotic ointment on the screw threads. It seems to make things go better when removing the screw. A stripped hex is frustrating. And I have had a few scares before changing the wrench out! Good luck. Bill

First use an extraction forceps, like a lower anterior, with fine beaks. If this does not work, just cut extensions from the center of the cover screw to both ends, making a groove for a screw driver, and Voila ! Your cover screw will open But make sure you dont cut a part of the collar of the implant. All the best.

all great ideas, let us know which one worked or didi not work!