Dentist placed screw retained bridge in mouth with 3i Biomet implants. They torqued the lab screws in the patient's mouth instead of the gold screws. The dentist is now worried that the lab screws may break over time or break if any attempt is made to remove them.
I personally think that they should try removing the lab screws. Any advice on how to proceed?
The gold screws are purportedlu designed with an elastomeric property so that after they are slightly streached at the proper torque level, they attempt to return to their previous unsteached size/length thereby clamping into the implants threads more suffiently than a harder lab screw. As Mr Coon also stated, the lab screws are rated to be used many many times and not break, whereas the goldtite screw is intended for one use ever to allow it the full designed effect on the securing of the abutment.
However, I've had to use the gold screw before in the lab on a Encode case, and seen lab screws used in the mouth. Leaving them in isn't neccesarily going to cause problems, but he *will* increase the percentage of chance of problems a few points. And the percentage over time will likely rise as the gold is intended to deform and adapt to the threads theoretically giving it total contact with the entire thread path and the lab screw is intended to be stronger and harder and therefor less adaptive resulting in an effectively smaller, smoother face between the screw and the mating screw threads.
One last consideration would be the warantee coverage of the restoration. Wrong screws = 3i says it's not our problem if anything goes pear shaped. They are nasty about this to the point that they will not even cover encode abutments made on quad models.
Sorry, brevity eludes me currently.
Edit:clarity