Fractured Abutment with Cold Welding: A Removal Case

Case Summary 🔎

Introduction

In long-standing internal type implant restorations, mechanical complications may occur over time.

One of the most challenging situations is abutment fracture combined with

cold welding, often making conventional removal techniques ineffective.

This case presents a fractured abutment in an old internal connection implant, where cold welding had occurred, resulting in prosthetic instability.

Using the All-in-One Remover Kit, the fractured abutment was removed safely and efficiently, without causing damage to the implant fixture.

Patient Information

• Age/Gender: 73-year-old, Female

• Past Medical History: Healthy

• Drug allergy: None

• Chief complaint: "I feel mobility in the lower right area."

Treatment Plan

1.  Removal of internal connection abutment using the abutment remover in

   All in one remove kit

2. Fabrication and delivery of a new zirconia prosthesis.

Case Presentation

1️⃣ Pre operative

• Pre operative periapical radiograph and photo

2️⃣ Abutment removal

• Incision and Flap Reflection due to cold welding, which prevented removal with conventional instruments.

• The abutment remover was fully seated onto the fractured abutment and firmly tightened using the FR driver to ensure stable engagement prior to removal.

• After connecting the 'Abutment Remover Grip,' it was rotated counterclockwise to remove the fractured abutment.

• The fractured abutment was completely retrieved without damage to the internal connection.

• After confirming the integrity of the internal connection, a healing abutment was placed and the procedure was completed.

3️⃣ Prosthetic Rehabilitation

• A radiograph was taken to confirm proper healing abutment placement, followed by intraoral scanning for fabrication of the new prosthesis.

• At two weeks postoperatively, the final prosthesis was delivered, demonstrating stable soft tissue healing and proper implant integration.

Conclusion

This case illustrates that even in the presence of cold welding associated with a fractured abutment, controlled removal is achievable without compromising the integrity of the internal connection. Careful assessment and the use of an appropriate removal system allowed preservation of the implant fixture, enabling subsequent prosthetic rehabilitation without additional surgical intervention.

https://www.youtube.com/watch?v=L0svx8FDMK4