Loose abutment screw on unknown implant?
I have been sent a patient with a loose abutment screw on the distal implant (tooth 46). The implant is over 10-years old – placed in the UK. I haven’t seen the patient before – (I can see CBL on 45 and the spacing is odd). At this stage, I am trying to work out the manufacturer so I can figure out a compatible driver and likely torque for the abutment screw so we can consider replacements once other factors have been checked. Any help would be gratefully appreciated.
7 Comments on Loose abutment screw on unknown implant?
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Mwjddsms
10/1/2019
Those look like Nobel active implants. Biggest issue is who is the abutment manufacturer. Different companies use different head designs. All use the star driver from Nobel. Hopefully the restoring dentist used OEM parts so you can simply order a screw from Nobel. Call the restoring doc for abutment info. Note to readers, now that we have conical connections, a precise fit of abutment to implant is crucial to minimize screw loosening. OEM parts are more important than ever
Carlos Boudet, DDS DICOI
10/1/2019
Even the "universal" prosthetic kits such as the one available here, do not have all the drivers.
Narrow down the implant companies using the radiograph and then ask them to help in the identification, then get the appropriate tools/drivers.
You will get to the point where you will have most of them available.
Also, it does not hurt to open the access hole and inspect the screw head. Many times you will have the driver necessary even if you haven't identified the implant.
Good luck!
Dr. Gerald Rudick
10/1/2019
We have not been provided with photos, or know whether these crowns are cemented or screw retained...please provide more information in order for us to hel you.
Greg Kammeyer, DDS, MS, D
10/1/2019
Following the above guidelines, especially replacing the screw, youlll do well. Keep in mind that once you have the screw out it will be easier to match it to the brand of Nobel or clone. Good luck
Jen
10/1/2019
NobelActive v with an internal conical connection
Jen
10/1/2019
I would also suggest getting a new screw instead of retorquing the old one. Nobel Ref# 36918. Use a unigrip or star insert and torque to 35Ncm with a 5 minute wait between tightenings to ensure you get maximum clamping of the screw. Seen multiple instances of loose screws with this conical connection. Aftermarket abutments and screws are a huge issue.
KenH
10/1/2019
I agree that it’s likely to be a Nobel Active conical connection
Replace the screw .... I’m wondering if it’s a Narrow platform
Carefully inspect the implant head. I have had 2 cases of my own where a NP Active in a molar location has had a crack in the implant heading which then caused the screw loosening
