Screws for Prostheses on Implants are Loose: What are My Options?

Question:

Richard asks:

I had three dental titanium implants put in my lower right jaw in 1987. Seven months later my surgeon installed the abutments and my regular dentist installed the prostheses. They have served me well over the years.

Now though, I can feel a slight movement of the prostheses with my fingers. The x-ray shows them in perfect alignment, but with some bone loss. Over the years they have been removed three times to re-tighten the tiny screws. My dentist tells me I may have to have new implants if they won’t tighten up this time of if the screws are damaged when he removes the prostheses. I am 79 years old and in excellent health. I have the following questions:

1. Are there replacement screws for these type implants? If so could you provide a source?

2. Is there a way of attaching new abutments to the existing implants and crowning them with the new type prostheses or would the existing implants have to be removed by surgery? In the later case would this involve a bone graft or rebuilding bone some way?

3. Would it be wiser to just leave them as thy are, since they fill up the space and they don’t bother me any? I’ve been chewing on the other side since I noticed the problem.



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Expert Advice and Comments
Luis Berumen oral surgeon's picture

It is possible that yours

It is possible that yours implants are external connection, if is therefore the main problem is that screws become loose at certain long time but does not implant loose, in this case it does not solution, may be to change implants for internal connection
About bone less I dont know what about conditions has your bone (Rx and Tm)


R.S. Ponton's picture

Solution for a loose implant abutment screw

I think you and others would be interested in a new device I have invented to prevent an implant crown/abutment retaining screw from loosening.

My first dental implant is 16 years old, and became loose every one to two years requiring re-tightening by a dentist each time. It is an older style Sustain “Lifecore” implant without a locking joint between the implant and mating abutment/crown. It does not have the anti-rotational design – only a flat surface on top of implant and bottom of abutment/crown.

I eventually had wings installed on the crown and that helped; but did not totally prevent loosening periodically because the remaining rotation mobility caused the restraining screw to independently loosen about every two years. Before adding the wings, it loosened approximately yearly. I have had the screw replaced three times during this time.

Recently, the crown would only stay tight for several days. I had been working on a solution to correct the problem and my third design has been successful. I made the device from bio-compatible titanium and my dentist agreed to install it into my #30 implant crown/abutment. The implant crown/abutment is still tight after stress testing with all of the situations which caused loosening previously.

The solution is very simple, but to my knowledge, no other permanent solution to the problem exists. The common “fix” is to add a thread-locker chemical to the retaining screw threads which adds friction and restrains the screw from becoming loose. Eventually, the screw will loosen and the process is repeated ad nauseam.

More modern implants have a “locking-joint” design to prevent the abutment/crown from rotating independent of the implant, thus restricting the screw from loosening (usually). Apparently, this is not 100% successful based on comments posted on various web forums.

My Hex-Retainer™ device prevents the retaining screw from loosening independent of the abutment/crown, thus keeping the assembly tight.

Three other points of consideration concerning the Hex-Retainer device:

1- there is no contact with tissue or bone,
2- it does not detrimentally alter the design intent of the implant system,
3- it can be removed later with no damage or alteration to the screw or implant system

I discussed the device with my general dentist and three implant surgeons and all think it is a viable solution to the problem.

Last week, I received an order for two of the Hex-Retainer devices from the dental practice who installed mine. I machined them from bio-compatible titanium and shipped them Friday.

My company specializes in solving unique industrial and high-tech problems and this unique device solved a personal need.

I am applying for a patient on this device and a related device (Retriever Loop) which I also developed. It is used to retrieve the Hex-Retainer from the crown/abutment screw access hole in the event that the crown/abutment must be removed and the device can not be retrieved with tweezers.

If you or others have a need for this device, or if you have any questions, let me know.

Best Regards,
R.S. Ponton, President
ICE (International Carbide & Engineering, Inc.)
P.O. Box 216
5000 Main Street
Drakes Branch, VA 23937-0216 USA

Phone: 434-568-3311
Fax: 434-568-3421
Email: rsp@ice-va.com
Web: http://www.ice-va.com


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