Management of Broken Dental Implant Abutment in a Patient with Bruxism: A Rare Case Report and Review of Literature

Management of Broken Screw Inside Implant Screw Channel: A Case Report

RATIONALE

This case report outlines a novel prosthodontic approach for managing a broken screw inside an implant screw channel, emphasising the importance of innovative solutions in implant dentistry.

PATIENT CONCERNS

A 57-year-old male patient sought restoration for implant-supported crowns (#46 and #47). A broken screw inside the implant screw channel posed a significant concern for both the patient and the dental team.

TREATMENT

Utilising an impression pickup technique of the inner surface of the implant body, a custom titanium abutment was fabricated in the laboratory and restoration was successfully replaced. A follow-up of 6 months was performed, ensuring optimal function and patient satisfaction.

OUTCOME

The custom titanium abutment with a zirconia crown was placed, leading to a successful restoration. The patient reported no discomfort, demonstrating improved function and aesthetics.

TAKEAWAY LESSON

This case highlights the effectiveness of tailored prosthodontic interventions in addressing complex implant-related complications.

Cementum is key to periodontal tissue regeneration: A review on apatite microstructures for creation of novel cementum-based dental implants

The cementum is the outermost layer of hard tissue covering the dentin within the root portion of the teeth. It is the only hard tissue with a specialized structure and function that forms a part of both the teeth and periodontal tissue. As such, cementum is believed to be critical for periodontal tissue regeneration. In this review, we discuss the function and histological structure of the cementum to promote crystal engineering with a biochemical approach in cementum regenerative medicine. We review the microstructure of enamel and bone while discussing the mechanism underlying apatite crystal formation to infer the morphology of cementum apatite crystals and their complex structure with collagen fibers. Finally, the limitations of the current dental implant treatments in clinical practice are explored from the perspective of periodontal tissue regeneration. We anticipate the possibility of advancing periodontal tissue regenerative medicine via cementum regeneration using a combination of material science and biochemical methods.

In Vitro Comparison of Modes of Failures among Titanium and One- and Two-piece Zirconia Abutment under Static Load

Objectives  The objective was to assess modes of failures under static load (SL) among titanium (Ti) and one- and two-piece zirconia abutment (ZA) in vitro .

Materials and Methods  The Ti abutments were digitally scanned for the fabrication of the one- and two-piece zirconia abutment specimens. This was done to standardize the design of the one-piece abutment and make it the blueprint of the Ti abutment. Twenty-one implant abutments and 21 implant replicas were categorized into three groups as follows: group 1 (Titanium group), group 2 (one-piece ZA group), and group 3 (two-piece ZA group). A 250K-cycle, linear fatigue-load, reaching 10 to 210 Newton (N), was put on all specimens using an all-electric dynamic test instrument and the specimens were loaded until fracture.

Statistical Analysis  Assessment of mode of fracture among the groups was done visually. Significance was based below 0.05.

Results  Screw fracture ( n = 7) and abutment bending at the apical part ( n = 7) occurred in the Ti group. In the one-piece zirconia group, screw and abutment fractures occurred in seven and seven cases, respectively. In the two-piece zirconia group, screw fracture ( n = 7) above the Ti zirconia junction (transgingival segment) and abutment fracture ( n = 7) were determined as the failure modes.

Conclusion  In conclusion, all abutments underwent failures under SL in vitro ; and the mode of failure modes varied among the different abutment designs used.