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Ryan posted an update
WIN WEDNESDAY started as WTF WEDNESDAY
38yo Female
#25 was lost in a car accident and replaced with this absolute beast of an implant @ 18yo
Last month, the patient presented with #26 broken off at the gumline, so I extracted it with the intent to remove the existing crown on #25 and replace it with a new custom abutment, crown and cantilever #26.
Did some digging and found that the implant was a Zimmer Spline Reliance Cylinder. My rep tracked down parts and I was set to go with removing the existing crown and abutment.
I found what I thought was the screw channel and proceeded to remove the cement that was covering it – totally expecting to find cotton covering the screw to protect me from damaging it.
Soon, the debris I was creating changed color and consistency and I stopped to check things out…
Well sh*t. I completely obliterated the screw head because it was filled with cement and not covered with cotton. Thanks previous doc 😅
Thankfully I bought a universal prosth driver kit on aliexpress for $50 and one of the hex drivers engaged the destroyed screw head just right so I could remove it without further incident.
Defintely didnt feel like a win in the moment.. but I’m grateful for the challenge and proud of how we recovered from it.
Does anyone have any tips for avoiding this issue in the future??
jaya311, lewisluo and 3 others7 Comments-
I’m still on the edge of my seat here man! Did you have a replacement screw? 🍿
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@ivan-chicchon all along, my plan was to send her home with a healing collar
If I were more skilled i definitely could’ve aimed to remove the crown and abutment, take the impression, and put the crown back onBut I’m not there yet 🤣
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Not a fan of cantilever because it overloads the base implant to carry more weight and pressure than it was intended to, so that’s why I always avoid such a treatment plan. Now I do understand that we always have to work with what we are presented with and the problem with the case here is that the implant was supposed to be at a different angle so that right now you could have easily just place one on #26 and all good after that. I would personally still try to do that by using a 3.5 diameter implant 6-8mm in length (very important: placed at a different axis to the current long one and possibly even placed more anterior just to avoid a possible collision inside the bone) then get instant impressions with transfer abutments and make 2 temporaries on cad/cam. Then grab a beer and toast to Implant Club Implants 💪
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@javohiros I totally get where you’re coming from with that thought process! It was definitely considered but the patient preferred to avoid further waiting time.
With the existing implant being 12 feet long on a lower incisor, I’m hopeful it will be just fine 😂
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@RYAN you should have mentioned how long it was earlier. I thought it looked like a 6 footer and that’s why I suggested to insert another one. If it’s 12 feet long, then I’m confident it can act as a good cantilever 🤣
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@RYAN That thing is a beast man. I wouldnt be surprised if that thing outlasts every single tooth in that persons mouth. That’s the empire state implant
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@ivan-chicchon it’s crazy! I was shocked when I saw the PA
Do you think they used to go as long as physically possible when they didn’t have threaded implants?
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