JIACD
The Journal of Implant & Advanced Clinical Dentistry
Fractured Implant Fixture: What is the best way to handle it??
Sat, 07/24/2010 - 06:57 — sohail
I had this patient come in with a fractured implant #30.
I have not had much experience removing broken implant fixtures. I will eventually replace this with a new implant fixture. How do I get the implant out without destroying the buccal cortical plate?
Do I trephine it out? Should I replace it immediately with another implant and bone graft or should I bone graft and allow the site to heal first? What kind of bone graft would you recommend
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Comments
Fractured implant fixture: Get your trephine
Unfortunately you need to remove the implant. In rare instances you can prep the internal of the implant and do a cast post and core but the fracture needs to be high.
In the end you will probably remove the implant.
removing an integrated implant fixture
Trephination is the most common way to remove a fixture. You will need a trephine thats inner diameter is slightly wider the the fixture to be removed so that you can run the trephine around the fixture without hitting it. Salvin.com sells these as do other companies. Use alot of irrigation and intermittent apical advancement to prevent bone burning. since the resulting bone in the socket wont be ideal for integration it is not advised to immediately place a new fixture. graft the site close it and allow 3 months before rentry to place a fixture. You may loose a portion fo the buccal wall due to the trephination if that bone is thin between the implant and periosteum. Good graft to place would be IMHO Regenform, Dynagraft, Grafton verses the granular stuff.
Removing an integrated implant.
I know this sounds crazy but I have done this with extraction forceps. I grasped the outer platform aspect and used a counter clockwise motion. Do not use buccal lingual as in extracting a natural tooth. I do not think this will work in all cases.
Dont use a trephine to remove an implant: Use Piezo
Trephines I find remove what to much bone. I use the piezo to remove the implant and it works much better. Once you remove enough bone around the implant it can be rotated out.
Dont use a trephine or Piezo to remove an implant: Use KOPP
Trephines I find remove what to much bone. The piezo is much expensive. Use KOPP to remove the implant and it works much better and low cost. Once you remove enough bone around the implant it can be rotated out.
See more on http://www.implantkopp.com.br/arquivos/manual/1b20de6837.jpg
Or send a email to cientifico.kopp@gmail.com
Tomazinho can you expalin the KOPP?
The website wasnt in english. How does the kopp work, how does it remove the implant? The website I went to looks like it is an implant.
Thank you
Dr. Arroyo
KOPP is in portuguese
It is an internal engaging anti-rotational implant retriever which in reverse works braking the implant-bone integration for Implants:
1. Non-restorable Implants due to thier position
2. Failing Implant peri-implantitis
3. Fracture
FI: to remove implants with external connection or/and friction FI
FII: to remove Internal connection Implants or/and Friction FII
Implants with INTERNAL connection the internal threads need to be removed with the bur suggested TRI-HAWK BUR to allow enough space within the implant, other wise if inserting the implant retriever directly will cause the tip to brake inside the implant, making it wider will allow for deeper penetration into the implant to be reverse and fracture the osseointegration.
Once you have engaged the internal surface of the implant you will be able to use a hand wrachet to reverse the implant out. read this while you are looking the pictures on the link given before.
http://www.implantkopp.com.br/arquivos/manual/1b20de6837.jpg
Jorge E. Arce
Does Kopp = Anitua????
http://www.nxtbook.com/nxtbooks/specops/jiacd_201009/#/66
I read the above article and was impressed. Is the KOPP the same thing?