Dental Implant Screw Fracture: What It Means and Next Steps to Take

When the Screw Breaks: Understanding What Just Happened

You’re biting into your favorite sandwich, and then, crunch. But not the satisfying crunch of lettuce. Something doesn’t feel right. That tiny piece of metal you’re suddenly aware of? Yep, that might be a broken screw from your dental implant.

Sounds terrifying, but take a breath. Let’s walk through it together.

The screw plays a critical role in your dental implant. It’s the small but mighty connector that anchors the abutment (the part that holds your crown) to the implant body (which sits inside your jawbone). When a screw fracture occurs, it’s like the silent engine under the hood suddenly quitting. You may not see it, but everything relies on it.

Screw fractures can range from mildly annoying to genuinely disruptive. Understanding why the fracture occurred and how to fix it without damaging the implant is key. So let’s get into the nuts and bolts (literally).

What Is a Dental Implant Screw Fracture?

A dental implant screw fracture happens when the implant screw, usually made of strong titanium, snaps or breaks under pressure. It’s not the most common implant complication, but it’s also not exactly rare.

And here’s the kicker: implant screws are made to withstand a lot, but they’re not indestructible. Like any small screw under constant stress, especially uneven pressure on the screw from a misaligned bite or poorly distributed force, something’s gotta give eventually.

The fracture might occur suddenly, or it may build over time with tiny micro-movements weakening the structure. Either way, when the screw breaks, it’s time to act.

Causes of Implant Screw Fracture and Other Implant Complications

There’s no single cause. But the usual suspects include:

• Screw loosening and fracture over time, especially if proper screw tightening wasn’t done at the start

• Poor implant placement, leading to an angle that creates excess pressure on one side

• Implant and prosthetic misfit, meaning the crown doesn’t sit flush with the abutment

• The use of dental prostheses with cantilever extensions, which adds torque stress

• Biting forces, especially if you grind your teeth at night or eat jaw-busting foods

• Fatigue in the screw head over time due to repetitive load cycles

• Manufacturing inconsistencies (rare but possible), since not all screws are made exactly the same

The incidence of screw fracture is higher in cases with off-axis loading or when supporting a single implant crown in a high-load area like the molars. If you’ve had multiple loose screws over time, consider that a red flag.

Signs You Might Have a Fractured Implant Screw

Not every fracture is dramatic. Sometimes, it’s subtle. But here’s what to watch for:

• Sudden mobility of the implant crown

• Feeling like your bite is off

• Pain or discomfort around the implant

• A gap between the crown and gumline

• Clicking or grinding sounds when you chew

• The crown literally falling off (yep, it happens)

If the screw has broken, your dentist might confirm it after removing the implant crown and seeing the portion of the broken screw lodged inside the implant.

How Screw Removal Works Without Damaging the Implant

Screw removal is an art and a science. Your dentist will aim to:

• Identify the coronal portion of the fractured screw

• Use specialized screw retrieval kits or tools

• Sometimes create a groove on the screw fragment to engage the screw with an excavator to engage the fractured area

All of this is done without damaging the implant or its internal threads. A gentle hand and experience matter here. If the screw fragment is stuck too deep or the threads are stripped, implant removal might be the only option, but that’s a last resort.

What Happens If the Broken Screw Can’t Be Removed

If the broken screw fragment refuses to budge or the internal threads are too damaged to place a new screw, there are a few options:

• Remove the implant and place a fresh one later

• Use a custom abutment if possible

• Leave the implant and avoid using it functionally (not ideal, but possible)

Either way, management of fractured implant abutment screws depends on how deep the damage runs. Some cases require surgical intervention, while others can be handled chairside in your regular dental office.

Fixing a Broken Implant Screw and Getting a New Implant Crown

Let’s say you’re lucky. The fractured implant screw was retrieved cleanly, and the implant structure looks fine. You’ll probably need:

• A new screw

• Possibly a new abutment

• A freshly designed implant crown

In some cases, the removal of the fractured screw is followed by cleaning and evaluating the implant system for integrity. If everything checks out, a new screw and crown can be placed fairly quickly.

But if there’s been damage to the implant body or threads, you might face a longer road that includes removal of the fractured implant, healing, and implant placement again later.

The Management of Fractured Implant Screws: What Dentists Really Do

This is where the management of fractured screws gets technical. Dentists use tools and tactics like:

• Microsurgical techniques

• Reverse torque drivers

• Ultrasonic tips to vibrate the screw fragment loose

• Kits designed for the retrieving fractured implant screws

• Creative use of an excavator to engage the fractured piece and reverse it out

If the fractured implant is intact, you’re in luck. If not, expect more comprehensive management of implant solutions.

Prevention Tips So It Doesn’t Happen Again

A fractured screw isn’t always avoidable, but your chances drop dramatically with the right care. Here’s how:

• Make sure your dentist uses high-quality implant systems.

• Always get regular maintenance checks.

• Mention if you clench or grind your teeth.

• Don’t ignore signs of screw loosening.

• Avoid chewing ice or hard nuts on implant crowns.

• Replace worn abutments or implant crowns as needed.

Regular checkups allow early detection of screw loosening and screw fractures, letting your provider intervene before a full fracture of dental implants happens.