Today I want to talk about this specific instrument I learned about while having to retrieve a broken zirconia abutment. If you have read some of my previous posts, one of my most read posts has to do with broken implant screw removal. In my practice, I get referred for many implant related complications and one of them has to do with broken/loose prosthetic parts, be it the screw, the abutment, the crown or even the entire implant.
One time, I got a referral for a broken zirconia abutment. At the time, that was my first case of having to deal with broken abutment. I thought, if the abutment is broken, how hard is it to remove it if there are no screws attached. Well with the recent design of conical connection, trying to remove the apical part of an abutment with conical connection can sometimes be challenging. The challenge increases if there isn’t much to see or grab on with your hemostat and access to or visualizing the fragment is difficult. I am also not looking forward to drilling zirconia inside an implant.
As I was preparing for the case, I asked some laboratory technicians and their experience with zirconia abutments. Most tell me they stay away for them if the connecting interface is in zirconia. So not surprisingly now, most zirconia abutments will have a titanium base where the connection is metal to metal with the implant. Unfortunately, there are still batches of these zirconia abutments that have been used and are in direct contact with the implant interface. Overtime, if they do fracture, and if you find yourself the abutment is very much stuck to the implant due to the conical connection, you may want to consider buying this abutment retrieval tool. When I first learned about this tool, I found a video demonstrating on how to use it. It made it seem so easy. I had my doubts. But when the day came, it really took me one minute to remove the fractured zirconia abutment. It was worth the investment for me for this particular case.
And for me, I am not a big fan of buying gadgets. I often try to find ways to solve the problem without having to purchase anything specific for the case. It cuts down the cost for the patient. But for this, it was worth the investment.
You may say what else can I use it for? Well one of my pet peeves in dealing Angulated Screw Channel Abutments from Nobelbiocare is their loose metal adapter. If you are not familiar with this system, Nobelbiocare has a prosthetic solution where you can fabricate a screw retained restoration even if the implant is angled too far off from the ideal to a certain degree. It is called Angulated Screw Channel (ASC) Abutments. It has a metal adapter with conical connection to the implant below and an abutment/restoration above, most commonly utilizing zirconia as the restorative material. It is held together tight by an omniscrew requiring to use of a different driver (omnidriver). It is designed to be delivered as a screw retained restoration. But during try in, the metal adapter may separate from the restoration because of its tight conical connection. Trying to remove this metal adapter from the implant can be frustrating during try-ins procedures.
I have once asked a Nobelbiocare rep what they recommend in dealing with this problem. The answer I got was to either use an explorer/scaler that can reach deep enough beyond the metal adapter and release it by pulling it in the occlusal direction. Or you can order and use the abutment retrieval tool. In fact if you look at the manufacturers recommendation, that is recommended to use for ASC abutments.
That’s it. I just want to share this information to those who use Nobelbiocare products and are currently using conical connection for your restorations. This tool may come in handy one day for you. And for the record, I have no financial affiliation with the company. Have a great day!
Please check out my other posts too.