Salvaging an implant with fractured screw / custom cast post and core

[SeekingASolution]

Hi!

I am hoping for any input on this case, and if anyone can recommend any professionals who have worked on salvaging implants with cold welded screws, wither by retrieving the screws or making custom cast post and core fixed crowns / similar - or any other solutions.

Background: I have a narrow implant at 22 which has a fractured screw. Three attempts to remove it have failed. It's long (15-17mm) and well osseointegrated. I don't want to remove and replace it! I also am not keen on giving up on it and having it embedded with a gum graft and having a resin bonded bridge over the top, as I'm worried about the adjacent teeth having to be shaved down and overloaded.

Does anyone know of anyone who's done this work - in Australia or overseas? Or can you suggest where I can start looking?

Thank you!!!

 

[MattKW]

I can't see you have any option but to remove it. Implants are made to extremely tight tolerances and you can't repair them. Have you been to a prosthodontist to have the screw removed, or is it a general dentist? A prosdo might also have other ideas about how to replace the implant rather than a resin-bonded bridge (used in rare circumstances). The company reps for the implants are often very helpful, and know people who might also be able to help.

 

[SeekingASolution]

Many thanks for the reply.

Initially I went to the general dentist who placed the implant, then to a prosthodontist who recommended either a new implant or a bridge. He may have only recommended the bridge because I said I didn't want another implant. So I came to the same conclusion - it would need to be removed. Then I saw a periodontist for an unrelated area, and he considered a new implant a 'challenging non-pragmatic option' because of the length (15-17mm) and its osseointegration. I was reluctant anyway so this started me looking for alternatives, and I read many articles about fractured screw removal techniques, and a few about a post and core approach.

I have also contacted Neoss and am hoping they will get back to me.

In the meantime I will keep looking!