Repairing the Fractured Implants
The right distal implant is exposed and the fractured hexagon is removed with a diamond bur, leaving a rough surface.
A guide is then screwed in, to guide the polishing burs and center them on the long axis of the implant.
Low-speed carbide burs are used to flatten and polish the implant’s surface.
A double-threaded screw is connected to the implant. A cyanoacrylate glue (Loctite 4061, Henkel, Dusseldorf, Germany) is used for additional retention of the screw and the restoration.
An SOS tissue-level abutment base is connected to the implant, and will be used as a housing for the ChairSide 2 telescopic retainer.
A bone graft is added (Bond Apatite, Augma Biomaterials, Pardes Hana, Israel) and the flap is repositioned and sutured.
The left distal implant undergoes a similar procedure.
The double clockwise-counterclockwise thread of the SOS fixation screw requires the use of two ratchets to fasten the screw and fix the SOS abutment base in place.
At this point, we need to build the ChairSide 2 inverse telescopic abutments on the implants repaired with SOS. To maintain parallelism between these abutments and the mesial ChairSide 1, we will use the patented Abracadabra Parallelomaker.
The Abracadabra Parallelomaker
Sleeves are placed on the ChairSide 1 mesial abutments, and the Parallelomaker arms are connected.
Composite is then injected in the ChairSide 2 abutment bases on the distal implants, and the Parallelomaker is connected to keep the abutment formers in place.
In the end, the ChairSide 1 mesial abutments height is reduced. The ChairSide 2 abutments are seen distally. Note their supragingival height - only ~1mm above the soft tissue.
The old denture is relined and telescopic sleeves (for ChairSide 1) and attachments (for ChairSide 2) are fixed. The sleeves and attachments are made of PTFE and perfectly parallel to each other.
The patient goes home with a temporary denture. A permanent denture can be delivered after healing of the soft-tissue.
Panoramic X-ray showing the repaired implants and the new telescopic ChairSide 1 and SOS-ChairSide 2 abutments.
Follow-Up and Permanent Denture
The permanent denture was delivered to the patient after 1 month.
Note that while the telescopic sleeves of ChairSide 1 are made of PTFE, the telescopic retainers of ChairSide 2 are metallic.
Follow-up 3 months after the procedure. Note the ChairSide 1 and ChairSide 2 telescopic abutments, and their parallelism. Note the healing of the peri-implant mucosa following the procedure.
This SOS case is a sample case, performed at the ABraCadabra clinical support center in November 2018.
- Prosthetics and Surgery: Dr. Ian Hönig, Dr. Avi Glickstein, Dr. Vladislav Dvoyris
- Follow-up: Dr. Alex Rachlis
- Lab: Marcel Madioni, MDT - Abracadabra Technical Support Center