Discussion : Temperature rise during removal of fractured components out of the implant body: an in vitro study comparing two ultrasonic devices and five implant types [1]
Several techniques have been described to deal with biomechanical complications. Acquiring adequate visibility and access is essential to success which will require the use of a dental microscope.
Several mechanical approaches to remove screw remnants can be employed. Generally, after identifying the position and condition of the screw remnant, it can be carefully removed using manual instrumentation. A fine-tipped hand instrument may be wedged between screw and implant. If this fails to do the trick, the use of a round burr applying occlusal pressure and turning counter clockwise may loosen the fragment. When a flared burr is wedged between implant and screw remnant, the drill should make a clockwise action, to direct the screw in the counterclockwise direction. Cutting a deep slot in the screw and subsequently removing it with a bladed screw driver has also been advised. The use of rotary instrumentation may cause damage to the cranial inner portion of the implant body. If that occurs, even when the fragment (finally) loosens, it will not screw out, and this complicates matters considerably.
Most implant suppliers, and also some third parties, provide specific instrumentation to remove broken screws from implants (i.e., Certain screw removal kit, Biomet 3I, Palm Beach Gardens, United States; screw removal kit NobelReplace, Nobel Biocare, Göteborg, Sweden; Neo screw remover kit, Neobiotech Co, South Korea). In general, they screw into the center of the screw remnant, which facilitates another burr to grip it and remove it counter clockwise or fragmentate the screw remnant.
The use of ultrasonic equipment has also proven to be effective in dislodging fixed screw remnants at the risk of damaging the inner portion or overheating the implant. Hence, the use of magnification is a must and cooling may be advisable, but compromises the vision of the operator. The present study evaluated heat accumulation in vitro and the efficiency of cooling when using two types of ultrasonic equipment to the inner portion of several implants.
Serial posts:
- Abstract : Temperature rise during removal of fractured components out of the implant body: an in vitro study comparing two ultrasonic devices and five implant types
- Background : Temperature rise during removal of fractured components out of the implant body: an in vitro study comparing two ultrasonic devices and five implant types [1]
- Background : Temperature rise during removal of fractured components out of the implant body: an in vitro study comparing two ultrasonic devices and five implant types [2]
- Methods : Temperature rise during removal of fractured components out of the implant body: an in vitro study comparing two ultrasonic devices and five implant types
- Results : Temperature rise during removal of fractured components out of the implant body: an in vitro study comparing two ultrasonic devices and five implant types [1]
- Results : Temperature rise during removal of fractured components out of the implant body: an in vitro study comparing two ultrasonic devices and five implant types [2]
- Discussion : Temperature rise during removal of fractured components out of the implant body: an in vitro study comparing two ultrasonic devices and five implant types [1]
- Discussion : Temperature rise during removal of fractured components out of the implant body: an in vitro study comparing two ultrasonic devices and five implant types [2]
- Discussion : Temperature rise during removal of fractured components out of the implant body: an in vitro study comparing two ultrasonic devices and five implant types [3]
- Conclusions : Temperature rise during removal of fractured components out of the implant body: an in vitro study comparing two ultrasonic devices and five implant types
- References : Temperature rise during removal of fractured components out of the implant body: an in vitro study comparing two ultrasonic devices and five implant types [1]
- References : Temperature rise during removal of fractured components out of the implant body: an in vitro study comparing two ultrasonic devices and five implant types [2]
- References : Temperature rise during removal of fractured components out of the implant body: an in vitro study comparing two ultrasonic devices and five implant types [3]
- References : Temperature rise during removal of fractured components out of the implant body: an in vitro study comparing two ultrasonic devices and five implant types [4]
- Acknowledgements : Temperature rise during removal of fractured components out of the implant body: an in vitro study comparing two ultrasonic devices and five implant types
- Author information : Temperature rise during removal of fractured components out of the implant body: an in vitro study comparing two ultrasonic devices and five implant types
- Additional information : Temperature rise during removal of fractured components out of the implant body: an in vitro study comparing two ultrasonic devices and five implant types
- Rights and permissions : Temperature rise during removal of fractured components out of the implant body: an in vitro study comparing two ultrasonic devices and five implant types
- About this article : Temperature rise during removal of fractured components out of the implant body: an in vitro study comparing two ultrasonic devices and five implant types
- Figure 1. Implant embedded in epoxy resin with thermocouple at the outer surface. : Temperature rise during removal of fractured components out of the implant
- Figure 2. Results for all implants instrumented with two tested ultrasonic devices, either with or without cooling. (a) Temperature rise when instrumenting with the Satelec ultrasonic device without cooling. The horizontal dotted line denotes the assumed critical rise in temperature. Temperature rise at 30 s: bone level 3.3 mm > bone level 4.1 mm > Straumann regular neck 3.3 mm = Astra 3.5 mm = Straumann regular neck 4.8 mm. (b) Temperature rise when instrumenting with the Satelec ultrasonic device with cooling. The horizontal dotted line denotes the assumed critical rise in temperature. Temperature rise at 30 s: bone level 3.3 mm = Astra 3.5 implant > Straumann regular neck 3.3 mm = Straumann regular neck 4.8 mm. Temperature rise at the bone level 4.1 implant lies in between the bone level 3.3 mm and Astra 3.5 mm implant and both Straumann implants, but not significantly different from either of these implants. (c) EMS without cooling. Temperature rise at 30 s: bone level 3.3 mm = bon