Repair Procedures

Removal and retrieval of implants

and abutments


 Contents Introduction 3

Abutments and Screws

Undamaged abutments - Removal 4

Damaged abutments - Retrieval 7

Fractured abutments - Retrieval 8

Implants
Undamaged implants - Removal 9

Damaged implants - Retrieval 11

Osseointegrated implants - Retrieval 12

Threads

Reconditioning of implant and abutment threads 13

Implant Identification Tool 14

Instruments 16


Introduction
For different reasons abutments, implants or screws occasionally need
to be removed and replaced. The Astra Tech implant system has a wide
selection of different abutments to meet specific clinical ­situations.
­Provided the abutment screw is undamaged, cement-retained
­abutments can be easily removed or changed, in most cases, using hex
screwdriver.

This manual contains detailed instructions and illustrations on how to

remove, retrieve and recondition components. It also includes a guide
on how to identify implant sizes in the mouth.


 Abutments and Screws
Removal of undamaged abutments
with removal grooves

Abutments for screw-retention supplied with removal

grooves, i.e. UniAbutments and Cresco™ Inserts, can be
removed with the Removal Tool M1.4.
Removal Tool M1.4,
Short and Long

1. Place the Removal Tool M1.4 onto the abutment/

insert. Make sure the ridges in the Removal Tool
seat properly and engage the removal grooves in
the ­abutment/insert. Tighten the screw with a Hex
Screwdriver.

2. Attach the open-end wrench or any of the

­ratching wrenches in the ”OUT” position on the
­Removal Tool. Release the abutment/insert by
­turning it counter-clockwise with a firm, short
­movement.

3. Unscrew manually when the abutment/insert

is loose. To remove the abutment/insert from the
Removal Tool, loosen the screw, which will separate
the parts.


Removal of undamaged abutments
without removal grooves
UniAbutments without removal grooves, can be removed
using an Abutment Adapter.
This instrument can also be used for ­UniAbutments and
Cresco Inserts with removal grooves.

Abutment Adapter,
Short and Long

1. Adjust the lock nut of the adapter until a gap is

visible between the O-ring and the metal (1-2 mm).

2. Make sure to keep the gap while mounting the

adapter to the abutment/insert with finger light
torque.

Note! Do not compress the O-ring.


 3. Attach the open-end wrench on the lock nut and
attach any of the ratching wrenches in the ”IN“
position onto the adapter head. Tighten/activate
the adapter by ­moving the two instruments towards
each other.

4. When tightened/activated, use the wrench on the

lock nut with a firm, short movement counter-clock-
wise to release the abutment.

5. When the abutment is released, manually

­ nscrew the abutment completely.
u

6. Detach the adapter from the abutment with the

open-end wrench and any of the ratchet alternatives
in the ”OUT” position. Move the ­instruments away
from each other to loosen/deactivate the adapter.


Retrieval of damaged abutments
While the methods previously described can be used for removing fractured
abutments with intact threads, in most cases, using an UniAbutment Retriever
is a more efficient method. An UniAbutment Retriever must also be used to
retrieve abutments with damaged threads.
UniAbutment
Retriever

Note: Using an Abutment Retriever for undamaged abutments with undamaged

threads will cause damage to the threads during retrieval.

1. Place the UniAbutment ­Retriever in the

threaded hole of the abutment and turn
counter-clockwise while pressing down until it
­friction fits in the threads.

In situations when only a short fraction of the screw

hole remains, it may be difficult to achieve friction
enough. In such instances, cut or grind off some of
the instrument tip and try again.

2. Apply the open-end wrench and continue the

counter-clockwise rotation while maintaining a
downward pressure until the abutment loosens.
Continue manually until the abutment is completely
detached.


 Retrieval of fractured abutments, inserts and
bridge screws
Screw fractures may occur in implants as well as in abutments/inserts when
infavorable stress or force are applied. The remaining screw fragments may be
retrieved with Fragment Fork instruments.
For abutment screw fractures in implants and inserts with 2.0 mm threads,
Fragment Fork
use a Fragment Fork 1.4.
1.0 and 1.4
Use a Fragment Fork 1.0 in instances where implants have 1.4 mm or 1.6 mm
abutment screws or for bridge screw fracture in UniAbutments and Cresco™
Inserts.

1. The Fragment Fork is designed to be used

c­ ounter-clockwise and can often be used without
damaging the threads. Connect a Fragment Fork to
the Contra Angle. Set the Drill Unit to 300 rpm in
reverse direction. Place the point of the Fragment
Fork on top of the screw fragment. Press intermit-
tently while running the motor.

2. Continue to work on the fragment until it is

retrieved enough to be accessible with another
­appropriate instrument for complete removal.

The same procedure can be used with a Fragment

Fork 1.0 mm for bridge screws that have fractured
in UniAbutments or Cresco Inserts.


Implants
Removal of undamaged implants
During installation procedures removal of implants can usally be made with the
Implant Driver and reversing the rotation.
Another method to remove, undamaged non-integrated or partly integrated
implants is to use the Implant Adapter.
Select the appropriate Implant Adapter 1.6 or 2.0 depending on type of implant.
Implant Adapter 1.6 is used for OsseoSpeed™ Implants 3.5 S and 4.0 S
Implant Adapter M1.6,
REF 24610 – 24616 and 24620– 24626.
Short and Long
Implant Adapter 2.0 for all other implants.

1. Adjust the lock nut of the adapter until a gap is

visible between the O-ring and the metal (1-2 mm).

2. Make sure to keep the gap while mounting the

adapter in the implant.

Note! Do not compress the O-ring.


 3. Attach the open-end wrench on the lock nut and
any of the ratching wrenches in the ”IN” position on
the adapter head. Tighten/activate the adapter by
moving the two instruments towards each other.

4. Unscrew the implant counter-clockwise with the

wrench.

5. When the friction becomes less it may be pos-

sible to continue to screw out the implant with any
of the ratching wrenches in the OUT position. If
the adapter deactivates/loosens, continue with the
above recommended procedure after repeated
tightening/activation of the adapter.

6. When ready, detach the adapter from the implant

with the open-end wrench and the ratchet instrument
used in the ”OUT” position. Move the instruments
away from each other to loosen/deactivate the
adapter.

10
Retrieval of damaged implants
Removal of damaged implants or implants with damaged internal threads may
require alternative methods, e.g. the use of the Implant Retriever. The Implant
Retriever will fit in any of current or earlier implant product lines. It is designed
to squeeze in the threaded area and create a friction grip when rotated counter-
clockwise.

1. Place the Implant Retriever in the threaded

area of the implant and turn counter-clock-
wise while pressing the retriever down until it
sticks in position.

In situations when only a short fraction of

the screw hole remains, it may be difficult to
achieve enough friction. In such instances, cut
or grind off some of the instrument tip and try
again.

2. Apply the open-end wrench and continue the

r­otation while maintaining a downward pressure
­until the implant starts to rotate. Continue until the
implant is out of the bone.

11
 Retrieval of osseointegrated implants
If all other methods to remove a partly or fully integrated implant
are unsuccessful, a final option is to trephine out the implant. This
procedure should be used at the lowest possible speed under pro-
fuse irrigation and with the bone exposed for optimal visibility.
The Trephine Drills have slots for easier cleaning that also serve as
depth markings. Please see illustration below.
Trephine Drill
3.5, 4.0 and 5.0.

Use Trephine Drill 5.0 for

implant 4.5.

1. Select the ­appropriate trephine drill and mount it

in a Contra Angle.

2. Drill under profuse irrigation and make sure

to ­follow the axis of the implant. Creating a start
groove in the periphery of the implant with a round
bur or similar can help start the trephine drilling.
Continue to drill until the top of the implant reaches
the appropriate depth marking.

3. Lift out the implant with a pair of forceps,

­ emostat or any other appropriate instrument. If
h
needed use the Implant Adapter or the Implant
Retriever as described above.

12
Threads
Reconditioning of implant or ­abutment threads
Slightly impaired implant or abutment threads may be reconditioned with thread taps.

Thread Tap 1.4 mm can be used for all UniAbutments and Cresco™ Inserts and for the
smallest thread in the MicroThread™ - OsseoSpeed™ Implants 3.5 with REF 24510–24516.
Thread Tap 1.6 mm is intended for OsseoSpeed Implants 3.5 S and 4.0 S with
Thread Taps M1.4,
REF 24610–24616 and 24620–24626. M1.6 and M2.0
Thread Tap 2.0 mm will work in all other Astra Tech implants not mentioned above
and for the wider thread in the ­MicroThread - OsseoSpeed Implants 3.5 with
REF 24510–24516.
The threads can also be used in all CtC (Convert to Cresco) inserts in the Cresco portfolio.

The following instructions are the same for both implants and abutments.

NOTE: Only use the Thread Taps with a manual

procedure.

1. Attach the appropriate Thread Tap in the Driver

Handle.

2. Insert the tap carefully and make sure

to engage it properly in the threads.

3. Work intermittently with the tap about half of a

turn at a time and reverse in between to clean out
possible fragments. An appropriate lubricant will
facilitate the procedure. Remove tap completely now
and then and spray/rinse the thread and tap and if
needed re-lubricate before continuing.

13
 Implant Identification
Identification of implants, step by step.
If information about size of an implant is unavailable, the use of an Implant Identification Tool
can be useful in determining the type of implant placed in a patient’s mouth. The tool has a
double function with a hexed part and a screw part. Please see instructions for use below.

Hex
Implant Identification Tool
REF 22774
Used to identify which implant type you
are working with.

Screw

STEP 1. (A-D)
Insert the hexed end of the Implant Identification Tool into the implant:

1A. If the tool is unstable and rotation is possible

(indicating that the hex is not engaged),
then it is an

OsseoSpeed™ implant with a large

*
implant-abutment connection. Lar ge

Lilac

1B. If rotation is possible but the tool is stable

(indicating that the tool has engaged with the cone),
then it is a

Previous OsseoSpeed™ implant 4.0 *

(*) For each alternative, contact area between Implant Identification Tool and implant is marked in red.

14
1C. f the tool does not insert completely into the im-
plant and rotation is possible ­(indicating that the hex
is not engaged),
then it is a

Previous non-indexed implant 3.5

*

1D. If the tool does not insert completely into the ­implant,
but is stable and rotation is not possible,
(indicating that the hex is engaged),

Then proceed to STEP 2, See below

STEP 2.
Insert the screw end of the Implant Identification Tool into the implant:

2A. If the tool cannot be screwed into the implant,

then it is an

OsseoSpeed™ implant with a small ­

implant-abutment connection.

Small

Aqua

2B. If the tool can be screwed into the implant, then it is a

Previous implant 3.5

15
 Instruments
Removal/Retrieval Kit

Removal/Retrieval Kit includes instruments removing or retrieving implant

components in different situations.

Removal/Retrieval Kit,
REF 22864

The kit includes the following instruments:

General instrument Instruments to restore damaged threads

Wrench,
REF 22124

Instruments to remove/
retrieve screw fragments
Thread Tap 1.4, Thread Tap 1.6, Thread Tap 2.0,
REF 22871 REF 22873 REF 22875

Instruments to remove/retrieve
­abutments

Fragment Fork 1.0 mm, Fragment Fork 1.4 mm,

REF 22122 REF 22632

Abutment Adapter, Abutment Adapter, UniAbutment Retriever,

Short, REF 24424 Long, REF 24370 REF 22429

16
 Instruments to remove/retrieve implants

Implant Adapter M1.6, Implant Adapter M1.6, Implant Adapter M2.0, Implant Adapter M2.0,
Short, REF 24193 Long, REF 24194 Short, REF 24369 Long, REF 24368

Implant Retriever, Trephine Drill 3.5, Trephine Drill 4.0, Trephine Drill 5.0,
REF 22192 REF 22884 REF 22885 REF 22890

Other instruments

Other needed/usable instruments used in this instruction that are not included
in the ­Removal/Retrieval Kit are:

Ratchet Wrench, Surgical Wrench, Torque Wrench,

REF 24357 or REF 24178 or REF 24075

Driver Handle, Hex Screwdriver, Hex Screwdriver, Removal Tool M1.4, Removal Tool M1.4,
REF 24358 Short, REF 22514 Intermediate, REF 22515 Short, REF 24021 Long, REF 24037

17
 Notes

18
19
 78974-USX-0804
Astra Tech BioManagement Complex™
A successful implant system cannot be determined by one single feature
OsseoSpeed™
alone. Just as in nature, there must be several interdependent features
working together. The following combination of key features is
unique to Astra Tech Implant System™:

• OsseoSpeed™ — more bone more rapidly MicroThread™

• MicroThread™— biomechanical bone stimulation

• Conical Seal Design™— a strong and stable fit
• Connective Contour™— increased soft tissue contact
zone and volume Conical Seal Design™

Connective Contour™

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