How to Fix a Broken Dental Implant Screw – A Case Report-Burbank Dentist Ramsey Amin, DDS Explains

How to Fix a Broken Dental Implant Screw – A Case Report-Burbank Dentist Ramsey Amin, DDS Explains

In the last 11 years of placing dental implants in Los Angeles I have only ever had to remove a broken screw on old implants placed 25-30 years ago. Dental implant abutment screws really don’t break anymore!

They used to break when cheap dental implants were used that had an “external hex” as opposed to an “internal connection.”  A dental implant is a screw within a screw.  The implant itself looks like a screw and then the implant abutment usually connects to the implant by a screw.  These screws are about 1.25mm with an allen hex on the end, and they are made of medical-grade titanium. It is the silver one in the picture. The green piece is not relevant.

Internal connection implants like I use take the force off the screw and place it on the connection or deeper in the implant.  The main reason for a screw to loosen or break on a well- placed implant is excessive bite force on the implant.  Keep in mind that your bite changes over time on your implant and that it can become excessive over time.

Other reasons a screw can loosen or break are:  poor quality implant, rounding out the connection by excessive force of placement, poorly casted screw seat in a screw-retained crown, or an abutment that didn’t get torqued properly.

The x-ray shows the broken screw still inside this implant.  That tiny piece is not easy to get out as it needs to be backed out about seven revolutions.  It is like trying to take out an eyeglass screw and the Phillips head is broken off.

Careful technique, patience, and a slow drill in reverse can grab the screw out.  Most dentists that are involved in implants have never done this.

This case happens to be an implant held in by a screw with a metal biting surface rather than a traditional white cemented crown. Many dentists often resort to extracting the entire implant over a broken screw…yikes!
Ramsey A. Amin, D.D.S.

Diplomate of the American Board of Oral

Implantology /Implant Dentistry

Fellow of the American Academy of Implant Dentistry
Burbank, California
Voted Best Dentist in Burbank -2006, 2008, 2010, 2011 www.burbankdentalimplants.com


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21 thoughts on “How to Fix a Broken Dental Implant Screw – A Case Report-Burbank Dentist Ramsey Amin, DDS Explains

  1. Julie Young

    My dental implant screw came out for 2 days before I could have it replaced. It was quite painful, but my surgeon said the implant was solid as a rock. Within a few hours I had more pain and swelling. The next day even more pain and swelling- couldn’t close my lips all the way… the pain is throbbing and severe, even after taking motrin around the clock and ice compresses. They didn’t clean my mouth or the implant hole out before they replaced the screw… I even asked about it and was told it wasn’t necessary. It’s the weekend of course, so the on call dentist put me on amoxicillin which I have been on for 24hrs now with not any real change in the pain or swelling. Will this get better soon, or may I need IV antibiotics? Please help, I am in so much pain and so miserable! 🙁

    Reply
    1. RamseyAminDDS Post author

      There is usually a bigger problem when a screw is becoming loose. There are a plethora of issues that may be happening like the stripped screw, a stripped internal hex on the implant itself, poor material on the implant, a heavy bite, a cast Gold abutment, or a over contoured restoration.

      Screw loosening is very uncommon and if it remains loose for a long time you may end up losing everything altogether. We need to see somebody very quickly. Cost can be variable because sometimes something that seems extremely simple ends up being highly complex.

      I hope everything works out for you.

      Very Respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      Reply
  2. Muhammad

    Thank you for your response. I am planning to call you Tuesday (tomorrow) to discuss. After that I will fly down to your office for extraction of this broken screw.

    Reply
  3. Muhammad

    I have broken strausman’s implant screw. It was broken while my dentist was delivering crown about 2 months ago in Hawaii. I have moved to North CA and went to implant specialist for broken screw removal. The specialist Doctor could not remove the broken screw yesterday. He said too much torque was used which broke off the screw. He tried reverse drill no luck said screw is too tight. Reverse drilling was dental tech’s idea, not the doctor’s and I am not sure if reverse drill method was done properly. Now I am scheduled next Friday to remove the implant surgically, bone graft and 5 months later start all over with new implant with a price tag of over $4100.
    I am not sure what to do need information in making this decision. I am not sure if this is the proper route. Any ideas Dr. Amin? I would appreciate any help.

    Reply
    1. Ramsey Amin DDS

      Hi Mohammed,

      Wow, that is not a typical story. Broken screws are not impossible to remove but they are difficult. I would assume that the head broke off and only the threaded portion is there. It should be able to be removed. It is very rare to break a screw on the insertion. I have never done that. Screw removal requires a lot of patience.

      I would try at least 1 more time with another dentist before removing the implant. Let me know if you end up in Burbank! It may cost less than a new implant!

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      Respectfully,

      Ramsey Amin DDS

      Reply
    1. Ramsey Amin DDS

      Hello koriko,

      Fixing a broken dental implant abutment screw is highly variable in cost.

      This is due to the fact that a single abutment screw may take 1 minute to remove or it may take 2 hours to remove. Also removing the broken abutment screw may require sacrificing your existing dental implant crown and abutment. This would require you to remake a brand-new abutment and crown. The angulation that the dental implant was originally placed in is going to be a big determining factor on the ability to retrieve and replace a broken abutment screw.

      Burbank Dental Implant Dentist Discusses Best Angle of Surgical Dental Implant Placement

      Very Respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      Reply
  4. raymond rittenhouse

    I had denist specialist in Columbus ohio he tried reveris drill he tried a pick to unscrew the pin denist said he could turn the pin about a haft turn I think he mest uwhat do youp the threades and could not get it out and charged me 450 dollars for nothing what do you think

    Reply
    1. Ramsey Amin DDS

      Hi Raymond,

      Ugh..broken screws are no fun. Have him try to re-thread the implant for a new screw once you get it out. Screw removal is not for the inexperienced dentist. Maybe find someone else.
      Sorry!

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      Reply
  5. Drhayatzrein

    I have an urgent problem and I need really a solution ,I have a broken screw in an implant I have placed and it’s not coming out what should I do.i tried many solutions but nothing seems to work,thankd

    Reply
    1. RamseyAminDDS

      Hi Doctor,

      What have you tried already? Please describe your technique in detail.

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry
      Burbank, California

      Reply
      1. Wale

        Hello Doc,
        Interesting article. Just had my first ( hopefully only) fractured abutment screw in 15 years. Been wondering how to get it out. Surgery was done only 2 years ago. Many thanks for the blog. I’ll come back to let you know if I have any joy. Wish me luck .

        Reply
        1. Ramsey Amin DDS

          Hi Wale,

          Yes, please keep me posted. It is not easy to remove broken dental implant abutment screws!
          Ramsey A. Amin, D.D.S.
          Diplomate of the American Board of Oral Implantology /Implant Dentistry
          Fellow-American Academy of Implant Dentistry

          Reply