Successful Drill Out of a Broken Dental Implant Abutment Screw

Patience is a virtue. This case was previously attempted by a dentist with standard loupe magnification. The external hex implant fixture interface revealed deformation and cold welding to the broken abutment screw. I classified this case as a type 4, the most difficult type.

Hard situation for doctors who restore dental implants is breakage of a screw holding an implant abutment in place. This inconvinient occurance usually leaves a fragment of the screw in the implant body. What to do to remove implant? Normally, this is a relatively simple task.First, place a small (1/2 round bur) in a low-speed handpiece. Lightly touch the bur to the broken fragment on the periphery of the broken screw. Often, the screw fragment will be unscrewed by the rotation of the ½ round bur. If it does not come out with this technique, try this next technique …Obtain a small screwdriver kit from a hobby shop or hardware store. These are readily available and are easy to use for the following: Use a ¼ round bur in a high-speed handpiece to make a 1 mm slot across the most occlusal portion of the broken screw fragment. Hold the handpiece firmly in order to avoid having the bur move into the implant body. Use a proper size “mini” screwdriver to remove the screw.