Implant Screw Loosening
Posted on 11/08/2013
We probably can all recall a screw related issue with an implant case. The screw loosened, the screw would not fully torque, the screw was not retrievable - these are all common scenarios in implant dentistry. And with the increased number of generic parts available, this particular issue will likely only increase.
How can we address this issue pro-actively to avoid situations where the patient is in the chair and the abutment fits well, but cannot be screwed securely down?
Here are a couple of recommendations we have found to be helpful:
1. Purchase a set of drivers for all implant systems. Two companies in particular sell drivers for virtually any screw type: Diamo Dent (1888-281-8850) and Implant Direct (1-888-649-6425). We like the Diamo Dent drivers very much and they have come in handy one more than one occasion. A full set won't cost more than $500. And it's certainly worth the investment.
2. Keep a set of extra screws at your office. Using the lab screws is really not recommended. The lab screws and unscrews the screw at least five times during the fabrication of the abutment and fitting. Even with a durable titanium screw, it is better to use a new screw when inserting the abutment into the patient. If you did not supply the parts for the lab, then ask the lab what screw they used. Ask them to send you an extra screw, or ask them the company information so you can buy some extra spare screws.
3. Ask the lab to specify which size screw they've used for the try in screw. There are some European companies with FDA registration that are selling generic screws. While the screws can work well, we have noticed on occasions that they require a .048" driver rather than a .050" driver. Most practices have a .050" driver. So, if you're finding that you cannot torque a screw down, it is probably related to the wrong size driver.
Thanks for joining us today. Have a wonderful weekend.
How can we address this issue pro-actively to avoid situations where the patient is in the chair and the abutment fits well, but cannot be screwed securely down?
Here are a couple of recommendations we have found to be helpful:
1. Purchase a set of drivers for all implant systems. Two companies in particular sell drivers for virtually any screw type: Diamo Dent (1888-281-8850) and Implant Direct (1-888-649-6425). We like the Diamo Dent drivers very much and they have come in handy one more than one occasion. A full set won't cost more than $500. And it's certainly worth the investment.
2. Keep a set of extra screws at your office. Using the lab screws is really not recommended. The lab screws and unscrews the screw at least five times during the fabrication of the abutment and fitting. Even with a durable titanium screw, it is better to use a new screw when inserting the abutment into the patient. If you did not supply the parts for the lab, then ask the lab what screw they used. Ask them to send you an extra screw, or ask them the company information so you can buy some extra spare screws.
3. Ask the lab to specify which size screw they've used for the try in screw. There are some European companies with FDA registration that are selling generic screws. While the screws can work well, we have noticed on occasions that they require a .048" driver rather than a .050" driver. Most practices have a .050" driver. So, if you're finding that you cannot torque a screw down, it is probably related to the wrong size driver.
Thanks for joining us today. Have a wonderful weekend.
