The Screw Head of the Dental Implant Broke Off. Is This Common? How Difficult to Fix?

I would not say this is a common event, but implant screws do sometimes break. It could be due to a defective screw or some other reason. When I've had to remove a broken screw I did it by carefully removing the screw with hand instruments. Notching the screw might be a good idea, but I wouldn't use a laser to do so. I've been told that broken screws can sometimes be vibrated loose ultrasonically, but I have not tried this myself.

I am not exactly certain what you mean by the "screw head". There is the healing abutment (placed after surgery while implant heals) and the prosthetic abutment (which is placed on the implant to support the new crown). If it is the prosthetic abutment that broke off and part of the screw is wedged or stuck in the implant body itself, it may be difficult or easy to remove depending on the skill of the dentist. Ask your dentist or seek out a PROSTHODONTIST (specialist in crown and bridge and implants) in your area to assist you to correct this problem. DO NOT LET YOUR DENTIST NOTCH ANYTHING. This may be irreversible and and destroy your implant forever. 

This is an extremely uncommon event in the hands of an experienced surgeon. This particular event is almost always due to one of two reasons. The first is lack of experience in placing dental implants. The reason the implant broke was because of too much torque placed on that particular implant. Whether it is from faulty implant (which is extremely rare if a legitimate implant brand was used, not a cut rate cheap implant company that the dentist used to save a few dollars) or a inexperienced dentist, too much torque was placed.  Removal is the only remedy. This usually needs to be done with a trephine bur. Using a laser against any metal object is tantamount to malpractice and is extremely dangerous.  I am curious as to what type of doctor placed this implant. The success rate would be excellent if removed  and replaced by a properly trained surgeon. Seek the help of a board certified Oral and Maxillofacial surgeon for help in this matter.  Beware of doctors that have only had a weekend course or two in dental implants. It takes several years of proper training to place implants safely,

Although not considered common I have seen broken implant screws occur from time to time. The interface between implant and abutment (or Implant Post) is retained by a screw that is torqued down to a certain amount of force that is recommended by the implant manufacturer. Assuming that there are no defective parts the specifics of the case must be considered to find out WHY this happened. Did the abutment or Post seat and fit accurately onto the platform of the Dental Implant? If not this could be the reason for Screw head fracture. Was the Implant Crown in a proper bite relationship with the opposing tooth? Additionally, was the right diameter Implant Platform selected? The retrieval of broken Implant Screws can be tricky and challenging. Usually there are specific retrieval kits made by the specific Implant manufacturer. I do not recommend  using a Dental Laser around Implants due to the amount of heat they generate. The retrieval of broken Implant parts takes patience and finesse but can be done in the right hands.

Unfortunately, it sounds like the tiny screw connecting the abutment (post) to the actual implant broke.  This is one of the rare complications we sometimes face in implant dentistry.  Retrieving the remaining screw is tricky.  I imagine your dentist will use a laser to remove any excess tissue and stop the bleeding in the area to get better visibility.  Then he will try to use a micro screwdriver to try and tease the screw out of the implant.   Sometimes it’s very difficult to accomplish this task, hopefully he’ll be successful.  Best wishes to your husband.

Implant restorations can be srew or cement retained. The biggest advantage of screw retained restoration is retrievability. Unfortunately sometimes screws brake. Depends on implant system that was used for your husband, but there are special instruments to facilitate removal of broken screw, and it can be done. Of course the more experienced doctors have "the bag of tricks" that they use in such critical situations.  Notching the remaining screw and unscrewing it sounds like a good plan, however I never heard using laser for that purpose. I can assure you with one, this procedure requires a lot of patience from the patient and the doctor.

Although not common, the occasional implant screw can fracture.  The remaining portion of the screw should be removed by mechanical manipulation.  Notching the screw body with a laser IS NOT THE WAY.  Lasers work by generating heat.  Heating an implant will destroy the bone securing the implant to the jaw at the bone/implant interface.  If the screw body is not too deep in the implant, it may be possible to use ultrasonics to vibrate the screw out of the implant.  The screw might be scored with a cutting instrument and backed out with a screw driver, but care must be taken to not damage the implant or the exposed screw threads on the walls of the implant.  When the screw can not be easily retrieved, removal of the total implant an its replacement is the only choice.

It is not common but it can happen. Many times bite forces are the reason that a screw in an implant gives . Extra and non axial forces can cause fatigue, and breakage

Aligned with other authors above, this is extremely rare. I think there was either improper torquing technique or manufacture defect that has led to the screw fracture. Laser is certainly not effective nor a good idea. It produces heat and that is not good for the implant. The best is to attempt to remove the screw. If not successful (in the event the screw part is to deep) there is nothing that can be done and implant must be removed altogether and plan for replacement.

Thanks

Dr. Kazemi

This can happen, the question is why did it happen? Are there not enough implants to support what is in place? Are the implants not parallel? Can you advise if it is single implant or overdenture?  

Getting the broken screw out is usually not a problem. There are several ways to get them out and most of the good implant companies offer assistance with this.  I would suggest that you find out what type of implant this is and why the screw broke and make any changes as necessary. This might prevent the problem from occurring again.