Repeated Abutment Screw Fracture during Implant-Supported Prosthesis Fabrication Due to Internal Fixture Defect: A Case Report and Management Strategy
Journal of Dental School,
Vol. 43 No. 2 (2025),
30 April 2025
,
Page 113-116
https://doi.org/10.22037/jds.v43i2.46596
Abstract
Objectives: Dental implants have a high success rate for patients without teeth. However, complications can occur, particularly those related to mechanical issues such as abutment screw fractures. This case report presents an unusual incident of repeated abutment screw fracture during the impression and prosthesis fabrication stages which can be considered the first reported case of screw fracture during the prosthetic fabrication, while it usually presents years after delivery. Case: A 65-year-old female patient presented with repeated fractures of the abutment screws during prosthetics procedures. The initial tightening of the abutment to 32 N caused the fracture, and subsequent analysis revealed defects in the internal surface of the patient's fixture that correlated with the abutment screw fractures. In a conservative management approach, transitioning to a lower torque abutment setting (20 N) was successful without complications. Conclusion: This case highlighted the critical importance of examining the internal structure of dental implants during complication management. The implant's internal surface defects indicate a potential relationship between incorrect insertion torque and mechanical failures.
- Dental Implants
- Abutment Screw Fracture
- Torque Management
- Mechanical Failure
How to Cite
References
Adell R, Lekholm U, Rockler B, Brånemark PI. A 15-year study of osseointegrated implants in the treatment of the edentulous jaw. Int J Oral Surg. 1981;10(6):387-416. doi: 10.1016/s0300-9785(81)80077-4
Resnik RR, Misch CE. Misch's contemporary implant dentistry. [St. Louis]: Elsevier; 2021.
Lindquist LW, Carlsson GE, Jemt T. A prospective 15-year follow-up study of mandibular fixed prostheses supported by osseointegrated implants. Clinical results and marginal bone loss. Clin Oral Implants Res. 1996;7(4):329-36. doi: 10.1034/j.1600-0501.1996.070405.x
Ekelund JA, Lindquist LW, Carlsson GE, Jemt T. Implant treatment in the edentulous mandible: a prospective study on Brånemark system implants over more than 20 years. Int J Prosthodont. 2003;16(6):602-8.
Brägger U, Aeschlimann S, Bürgin W, Hammerle C, Lang N. Biological and technical complications and failures with fixed partial dentures (FPD) on implants and teeth after 4 to 5 years of function. Clin Oral Implants Res. 2001;12:26-34. doi: 10.1034/j.1600-0501.2001.012001026.x
Schwarz MS. Mechanical complications of dental implants. Clin Oral Implants Res. 2000;11 Suppl 1:156-8. doi: 10.1034/j.1600-0501.2000.011s1156.x
Eckert SE, Meraw SJ, Cal E, Ow RK. Analysis of incidence and associated factors with fractured implants: a retrospective study. Int J Oral Maxillofac Implants. 2000;15(5):662-7.
Bakaeen LG, Winkler S, Neff PA. The effect of implant diameter, restoration design, and occlusal table variations on screw loosening of posterior single-tooth implant restorations. J Oral Implantol. 2001;27(2):63-72. doi:
1563/1548-1336(2001)027<0063:TEOIDR>2.3.CO;2
Mizumoto RM, Jamjoom FZ, Yilmaz B. A risk-based decision making tree for managing fractured abutment and prosthetic screws: A systematic review. J Prosthet Dent. 2018;119(4):552-9. doi: 10.1016/j.prosdent.2017.05.016
Chowdhary R, Sonnahalli NK, Gala JN. Implant abutment screw fracture and techniques of retrieval: a literature review based on a novel abutment screw fracture classification. J Osseointegr. 2023;15(1):32-9. doi: 10.23805/JO.2023.15.01.06
Melo Filho AB, Tribst JPM, Ramos NC, Luz JN, Jardini MAN, Borges ALS, et al. Failure Probability, Stress Distribution and Fracture Analysis of Experimental Screw for Micro Conical Abutment. Braz Dent J. 2019;30(2):157-63. doi: 10.1590/0103-6440201902401
Raju S, Nair VV, Karunakaran HK, Manjuran NG. Management of perishing implants with abutment screw fracture - A systematic review. J Indian Prosthodont Soc. 2021;21(3):229-39. doi: 10.4103/jips.jips_295_20
Brancacci E, García González S, Galve-Huertas A, Bennani A, Hernández Alfaro F, Aboul-Hosn Centenero S. Influence of Insertion Torques on the Surface Integrity in Different Dental Implants: An Ex Vivo Descriptive Study. Materials (Basel). 2023;16(6). doi: 10.3390/ma16062330
Gehrke SA, Pereira GMA, Gehrke AF, Junior NB, Dedavid BA. Effects of insertion torque on the structure of dental implants with different connections: Experimental pilot study in vitro. PLoS One. 2021;16(5):e0251904. doi: 10.1371/journal.pone.0251904
- Abstract Viewed: 146 times
- PDF Downloaded: 163 times