November 2021
The patient presented upon referral from Dr. S to retrieve a fractured abutment fragment from a Straumann 4.8 bone level implant in the #3 site. The case had been restored for approximately 2 years when the fracture occurred. The abutment was a TiBase design, of unidentified origin, with the fracture occurring at the base of the external titanium cylinder. Unfortunately, this type of fracture is not uncommon as it is in a stress riser zone at the weakest cross section in the pillar where the torsional loading from the molar restoration can deliver the most force. Following a preclinical explanation of the recovery protocol, the abutment fragment was “wobbled” loose with a custom throughbore tool. The implant was cleaned and in the absence of a titanium healing abutment a provisional silicone plug was placed to help control the tissue profile. The patient was advised to have a custom titanium abutment placed which would have a significantly thicker titanium cross section in the critical fracture area.
Clinical post -op views of the intact implant
Recovered crown views to illustrate the thin the fractured titanium cylinder wall and the molar sized crown which supplies the leverage to create the torsional loading which fractured the cylinder.
