Internal thread stripping

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Posted on By Sattar Syed In Failures

Pt is a male in his fifties. Pt is a clencher. Fixtures were placed back in 2012 along 30 and 31 areas. Pt recently came to me with cc of loose crown. I examined the pt and removed the abutment and crown placed an encode abutment and noticed that the abutment was loose and pt was cringing as I noticed movement from the abutment. I referred pt back to the specialist that placed the fixtures, thinking it is an implant failure due to the mesial cantilever and the clenching forces. The specialist said that the implant is fully integrated but the internal thread on #30 might be worn.
My plan is to restore # 29 with over contoured crown and have the specialist or myself remove #30 fixture and replace it with a new one and splint 30 and 31 as a single unit. One of my colleagues mentioned that I do everything else but to cement a new abutment on #30 and deliver a splinted 30 and 31 2 unit bridge. This will save the pt from going through surgery. My question is should I place a new fixture or cement a new abutment . Please kindly share your knowledge with me.
Regards,
Sattar Syed


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4 Comments

What internal connection is this implant system provide? If internal hex you can bypass the hex on the damaged implant and splint them without cement. Dr. Salama


Reply

This is an internal hex implant by 3I.. so you are suggesting to not cement the abutment on 30 but place the abutment on 31 and 30 and splint the restorations. Please kindly respond Maurice. As always I value your advise
Regards,
Sattar Syed


Reply

Yes, precisely. Bypass the internal connection of the abutment so it does NOT engage the internal connection but rests upon the implant on #30 and then splint both and screw retain. Dr. Salama


Reply

Thank you Maurice, as a safety measure, I will also reduce the opposing plunging cusps. As always I thank you for your support.
Regards,
Sattar Syed


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