Re: [ACEsthetics] screw fractured.

Since Wayne asked how to remove a broken screw, here is my story: 

I had an external resorption event that necessitated the removal of #5. Local anesthetic, 1 1/2 hours at OS removal with pneumatic periotome by Midmark (pretty cool) and then the tooth's roots were too intertwined to it get out without too much vertical bone removal (had enough bone, not long enough implant!) so I need grafting, ect for 4 months.  Placed 3i 5mm platform torqued in at 75 and an Encode healing cap placed.  Took Encode impression, and it was finally time for abutment and tooth.

Son tried to remove screw "clockwise" and overtightened, then stripped the hex fitting when trying to undo.  We couldn't get the screw out!  What to do? (lessons through experience are the best way to learn!) 

  We slotted the screw head with a 669 to the depth of the hex hole and tried using flat-bladed drivers to remove the screw. The drivers would bend.  We finally had to remove the occlusal surface of the Encode down to below the  screw head and in fact, removed the screw head.  Then we were able to hemostat the Encode out over the top of the screw shank and grab the shaft with needle holders to untwist it.  I now have my implant!

I was a great patient!

Mike

-----Original Message-----
From: Wayne Sutton [mailto:Waynesutton@sbcglobal.net]
Sent: Monday, April 01, 2013 1:18 PM
To: drvoller@comcast.net
Subject: RE: [ACEsthetics] screw fractured.

Most importantly to everyone, How did you get this out Ray?  :)

Wayne Sutton, DDS,FACE,FAGD,FDOCS,FADIA
1330 Medical Center Dr.  Suite #1
Rohnert Park, CA  94928

707-585-2555
707-585-3704 (fax)

www.SonomaSmiles.com
www.SuisunCityDental.com
www.YourCaliforniaCosmeticDentist.com
www.NorthernCaliforniaDentist.com

-----Original Message-----
From: acesthetics@googlegroups.com [mailto:acesthetics@googlegroups.com] On
Behalf Of Raymond J. Voller, DMD
Sent: Monday, April 01, 2013 10:12 AM
To: Jim DiPerna; nelson@regosmiles.com; ACEsthetics@googlegroups.com
Subject: [ACEsthetics] screw fractured.

The crowns and the implant abutment fit beautifully on this case, however
when I went to torque the screw down at 32 NCm, it fractured the screw.
Implant Direct 3.0..Hmm..Not sure I like this company any more!
LUCKILY I retrieved the screw without boogering up the top of the custom
implant, however I'm pretty sure that 32 NCm is NOT too much torque for
this, but correct me if I'm wrong.
I've been in dentistry for 32 years and this is my first screw fracturing.
Thoughts?
Ray

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