I have a patient referred from a partner clinic because they were unable to remove an implant-supported prosthesis. I’ve attempted removal myself using different approaches, including rotation and applying counter-support, but it won’t budge at all. As you can see in the images, there are multiple implants in place, and one of the abutments appears damaged. I suspect there might some mechanical locking preventing removal. Has anyone dealt with a similar situation? Any suggestions on techniques or tools that might help? I’d really appreciate any insights!
are you sure you have the correct driver? looks like same type of implants so abutment screw should be same. possible the abutment screw is stripped and your driver is not engaging the abutment screw?
There are no mechanical locking preventing removal. usually, a hex or triangle inside of the implant then abutment fit into that internal shape.
however the abutment screws and healing collars depending brand have different sizes and shape drivers. do you have a universal kit w/ different size/shape drivers? try each one. sometimes if screw stripped you can fit a slightly different driver and press hard with a torque wrench to turn the screw.
abutment screws usually torqued to 30Ncm. but your fingers can only torque 5-10Ncm. trying to unscrew an abutment screw manually is difficult.
are you unable to remove all of the healing collars and abutment screws? circle which abutments you cannot remove on your photos.
what a mess. some drs with limited implant training should not be doing full mouth rehab cases. Just because you can place single implant/crowns and 3-unit bridges. does not mean you can combine them to do full mouth rehabs. this results in patient suffering and are left with a mess for other dr to fix. Or dr perform what patients’ want or can afford with limited finances and produces subpar treatment result.
seems like the dr who perform this treatment for this patient did not plan this implant treatment crown down. instead, just haphazardly placed implants and try to fit a bridge over the implants.
good luck.
I am not sure what you are talking about since the prosthesis appears to have already been removed. If indeed you are referring to the abutment screws, rather than the actual prosthesis, then you are most likely dealing with stripped/partially stripped screw heads which could very well be of some aftermarket/copycat brand leaving you in a bad situation. At the very least try to track down the flavor of the screws in place and then start with the suggested hex driver… this of course is assuming that genuine parts/pieces were used. While this is no fault of yours it is a far to common situation today and I have found the number one culprit is the utilization of less expensive compatible parts on often times unidentified less expensive aftermarket screws… Good luck!!