Broken screw removal hack - Dr. Udatta Kher

Most abutment screws tend to fracture when they get loose and the patient does not report in time for its management. Hence most of the fractured screws are not heavily torqued in the implant. Some may be visibly mobile. Some may not be.

They usually fracture at the level of the platform allowing us a glimpse of the top of the screw.

My protocol is as follows
1. Clean exposure of the implant platform and screw
2. Using a high-speed drill (electric or air turbine) and a tiny round diamond bur
3. Magnification and illumination is mandatory
4. Touch the tip of the bur on the top of the broken screw and make gentle counterclockwise motions. This is done without irrigation to allow better visualization.
5. The screw pops off within seconds.

I've done this on numerous occasions and many more clinicians vouch for this unconventional yet effective technique.

For screws fractured at a level much below the platform, I'm not sure there is any predictable way of retrieving it. I have little experience in retrieving such a deep screw.

What I may consider in such a case, before I give up and plan to explant, is to let the apical end of the screw remain. And use a new shorter (trimmed down) screw to manage the case. Knowing well that is is only a short to a medium-term solution.

Watch the video here: Broken Screw Removal Hack

About the author:

Dr. Udatta Kher has made significant contributions to the field of implant dentistry. He has developed a wealth of clinical evidence on Socket Shield. He has also developed MITSA - an innovative technique that has simplified the sinus lift procedure and made it user-friendly for beginners. He is a well-known educator in implant dentistry, providing quality training through his academy 'Impart Education.' He and a team of top implantologists of India have authored a book "Partial Extraction Therapy"

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