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Cite this article as: J Can Dent Assoc 2014;80:e22
ca
ESSENTIAL DENTAL KNOWLEDGE
Published by
The Canadian Dental Association
jadc
Point of
Applied
Research
Care
DES CONNAISSANCES
DENTAIRES INDISPENSABLES
Publié par
l’Association dentaire canadienne
Managing Patients with a Loose Implant
Abutment Screw
Stewart Hum, DDS, Cert Prostho
Dental Emergency Scenario
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Loose Implant Abutment Screw
An implant-crown restoration that demonstrates mobility.
Presentation
Population
• Individuals with any crown restoration cemented on an implant abutment
• Greater prevalence among individuals with a bruxism and/or clenching habit
Signs
•
•
•
•
Loose implant-supported crown
Crown may be a cemented restoration over a prosthetic implant abutment
Mobility of the crown/bridge abutment with or without gingival inflammation
Possible redness or swelling of the surrounding tissues
Symptoms
• Pain severity: there may or may not be any pain or discomfort around the
crown; usually minimal or moderate pain.
• Manipulation of crown may illicit some rotational and possibly slight vertical
movement.
• The bite may feel different or high on the implant restoration.
• A bad odour or taste may be associated with the implant crown.
Figure 1: Radiograph reveals a microgap
between the abutment and the occlusal
platform of the implant. Also note that the
crown is not fully seated on the abutment.
Investigation
1. Confirm that there is no failure of the cement seal.
2. Identify the type of implant using radiographic examination. Check record of
restoration, or contact the dentist who placed the restoration and surgeon to
confirm the fixture type.
3. Palpate the crown restoration to reveal lateral mobility.
– Movement ranges from very minimal to 1–2 mm with “hard stop” (clicking
of metal on metal); a loose fixture would tend to have “soft stop.”
jcda
ca | 2014 | Vol. 80, No. 1 |
ESSENTIAL DENTAL KNOWLEDGE
Published by
The Canadian Dental Association
jcdaf
ca
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