Safe Removal of a Broken Abutment Screw with Customized Drill Guide and Rotary Instrument: A Clinical Report.

This clinical report introduces a method for safe retrieval of a broken implant abutment screw. A reverse-tapping rotary instrument has been introduced in the market and is widely used to retrieve broken screws; however, it is difficult to use the rotary instrument unless an access hole for engagement of the rotary instrument is positioned directly on the center of the top of the broken screw remnant. Poor visibility is another limitation to make an access hole. To keep the position of the rotary instrument at the center of the broken screw, a customized drill guide was fabricated, modifying an implant impression coping with self-cured acrylic resin, all easily found in daily practice. The broken screw was easily removed, not damaging the internal threads of the implant. This technique could be applied to most implant systems when a specific removal kit for each implant system is not prepared.