Management of a complication with a fractured zirconia implant abutment in the esthetic zone

Joda, Tim; Brägger, Urs (2015). Management of a complication with a fractured zirconia implant abutment in the esthetic zone. International journal of oral & maxillofacial implants, 30(1), e21-e23. Quintessence Publ. 10.11607/jomi.3827

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Technical complications in implant prosthetic cases represent a major challenge in dentistry. This case report describes minimally invasive management to recover an implant with a fractured remnant of a zirconia abutment, including provisional rehabilitation during a sequential treatment protocol in the esthetic zone. A patient was treated with a screw-retained one-piece implant-supported reconstruction made of a customized zirconia abutment with direct ceramic veneering in the maxillary right central incisor position. During the prosthetic try-in, a fracture in the apical portion of the abutment was evident. The first rescue attempt led to fracture of the retrieval instrument. Immediately, an individualized wired construction was applied to bond the existing fractured reconstruction to the neighboring teeth to maintain the peri-implant mucosal architecture. Because the implant screw canal was blocked, a customized round bur had to be manufactured and was placed in the implant axis with a specific bracket tool from the service set to protect the interior implant threads. Then, the drills of the service set were guided by the newly created access to remove the fractured remnants. The implant screw was retapped and the area rinsed with chlorhexidine solution. All remnants were removed without the need for surgical intervention. Neither the implant connection nor the bone-to-implant interface was damaged. The stepwise treatment approach with the customized round bur combined with the system-specific drills of the service set saved the blocked implant so that the patient could be successfully rehabilitated with a new implant reconstruction.

Item Type:	Journal Article (Further Contribution)
Division/Institute:	04 Faculty of Medicine > School of Dental Medicine > Department of Reconstructive Dentistry and Gerodontology
UniBE Contributor:	Joda, Tim, Brägger, Urs
Subjects:	600 Technology > 610 Medicine & health
ISSN:	0882-2786
Publisher:	Quintessence Publ.
Language:	English
Submitter:	Eveline Carmen Schuler
Date Deposited:	14 Apr 2016 14:05
Last Modified:	05 Dec 2022 14:53
Publisher DOI:	10.11607/jomi.3827
PubMed ID:	25615928
Uncontrolled Keywords:	abutment fracture, dental implants, implant-abutment interface, technical complications, zirconia
URI:	https://boris.unibe.ch/id/eprint/77771