I have a family member that had a tooth extracted, followed by an implant with a screw that was to have aa crown attached.
The implant was done in Dec 2019 and the plan was for the tooth to be attached in March. Due to Covid, the procedure was pushed to May. At the May appointment, the dentist found that a gum scrape around the implant needed to be done prior to attaching the crown. Once this was done, the dentist then attempted to attach the crown but ran into problems with the fit. The dentist forced until the screw completely broke.off into the implant.

After the break, the dentist made a referral to a specialist to extract the screw. This specialist charges $500 per hour. This specialist has unsuccessfully tried to remove this screw in 5 separate appointments. Costs are stacking up and the dental insurance has been maxed out long ago.

My question - Does the dentist have any liability for breaking this screw and the costs associated with correcting the problem that she created? Out of pocket costs for just the screw retrieval are over $2500 at this point and continued attempts involving different tool kits, 3D xrays are being pushed.

Think the Dentist should take responsibility as the the situation sounds strange. Things happen though.

I'm not saying what's right or wrong, but I'd be willing to bet there is some fine print somewhere the patient signed that said the dentist wouldn't be responsible for something like this.

I bet you're right. Apparently this occasionally happens, but the retrieval process is usually successful the first go around. In my mind, the dentist should be aware of the force required and if they are pressing beyond the normal limits required, they should stop and reassess. Forcing harder and causing the break sounds like negligence to me.

It's unfortunate but it can happen. The screw broke? Or stripped? If it was broken I would think the entire abutment/implant should just come out. Is the crown engaged but just loose in there ? What kind of specialist? Prosthodontist?
I feel like a good specialist would help bail out a referring dentist for minimal charge. If it were my patient I'd offer to cover the bill and settle with the specialist if I caused the problem.
I would talk to the original dentist. Atleast they may refund their portion of the crown or something to help out. If not then probably time to find a new dentist. Sorry to hear. Hopefully gets fixed.

el_scorcho said:

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I bet you're right. Apparently this occasionally happens, but the retrieval process is usually successful the first go around. In my mind, the dentist should be aware of the force required and if they are pressing beyond the normal limits required, they should stop and reassess. Forcing harder and causing the break sounds like negligence to me.

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Yes all manufacturers have a set torque and torque wrench for their products. Hard to see this happening unless a faulty screw from the lab/manufacturer or she indeed just wayy over tightened it.
I've had a screw strip before bc of a funny angle of engagement but never broken. But with a stripped screw if it's close to the torque specifications everything is stable and you can just leave it and it it should be fine unless you have to retrieve it for some reason.

Quote:

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The screw broke? Or stripped? If it was broken I would think the entire abutment/implant should just come out. Is the crown engaged but just loose in there ? What kind of specialist? Prosthodontist?

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The screw was inserted into implant that was made in December of last year. The plan was to do the implant, give it time to heal, remove the screw, attach the crown and then run down the screw. The dentist removed the screw, test fitted the crown, and then broke the screw when attempting to reinsert into the implant. This sounds like over-torquing to me. The specialist is a Prosthodontist.

Based on the number of failed attempts to remove the broken screw, I would assume removing the implant and making another is inevitable. There is a 3D scan scheduled for today, with the goal being a better view of how the screw lies in the implant. I question why this was not done right away, not after 6 separate attempts to remove the screw.

I got you. So is the crown still on there or just the broken screw ?
I feel like if you have the correct retrieval kit it should be fairly straight forward unless the screw broke very deep into the implant. In that case you may risk damaging the implant body itself which then yes you'd have to replace which would be a *****.
Sucky situation sorry bud hopefully the dentist makes it right.

Just the broken screw. It broke deep in the implant. And thanks for the perspective. This family member already has anxiety on normal dental visits, so this has been a real ordeal. Hoping they can salvage things with this 3D X-ray to guide.

What city was this in?

This is happening in Austin

el_scorcho said:

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Just the broken screw. It broke deep in the implant. And thanks for the perspective. This family member already has anxiety on normal dental visits, so this has been a real ordeal. Hoping they can salvage things with this 3D X-ray to guide.

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Just reading about this has increased my anxiety. I cannot imagine.

My dad just sold his practice in Austin to move back to East Texas. Bad timing. However, he is a great Periodontist and does implants if you are willing to drive.

3D X-ray result was reviewed and they said the implant is still solid. Maybe they'll get it out here soon. I'll update after I hear results of next retrieval attempt.