Screw loosening

[Brett Hansen CDT]

I fabricated a Straumann Zir abutment on a Straumann 3.5mm NN implant 2 years ago. We put a e.Max crown on top of it. The missing tooth was #10. It came back to us to re do it because the abutment screw came loose. The doctor talked with the Straumann rep about helping out with the cost of replacing the abutment and crown(abutment destroyed during crown removal). He said it wasn't protocol for Straumann to help out after a restoration has been cemented, but that he would supply a new impression coping and analog for free. I do alot of implant work with this doctor. Most of the restorations I do for him are Atlantis abutments on Straumann implants. I can't think of another instance of a screw loosening on any other case I have worked on with him. What factors lead to screw loosening? I know that poor crown retention is one of them. How do you feel about Straumann's policy about not helping out with the cost of replacing the abutment and crown? It seems to me that all three parties, lab, doctor, and implant company, should bear part of the responsibility in cases like this where there is no definitive reason for the failure of a restoration.

 

[Marcusthegladiator CDT]

The doctor should fix the problem for free. The lab should remake it at a discount, and straumann should discount as well.

But that's in a perfect world.

 

[cadfan]

with full zirconia abutments screws and recording are flat. There is a higher risk of screw loosening depending on the implant geometry. Nodges (eg Nobel Replace) take some of the forces acting on it still does not have the same torque and the conical tension as in example Hybridabutments. With Fullzirkonabutments from ICX, there was even a production error, the abutments were not tighten.

 

[doug]

Was it a Straumann abutment on their implant or an Atlantis abutment? Why should the lab be held responsible for a screw coming loose? If you're doing Atlantis abutments on top of Straumann, then Atlantis should stand behind their work. At what point in the process did the lab tighten the screw to the correct torque in the patients mouth? 35Ncm is a pretty tight screw. I wonder who outsourced that to their assistant?

 

[dmonwaxa]

I wanna hit the "Like"button over and over and over again.

Was it a Straumann abutment on their implant or an Atlantis abutment? Why should the lab be held responsible for a screw coming loose? If you're doing Atlantis abutments on top of Straumann, then Atlantis should stand behind their work. At what point in the process did the lab tighten the screw to the correct torque in the patients mouth? 35Ncm is a pretty tight screw. I wonder who outsourced that to their assistant?

 

[2thm8kr]

 

[Tayebdental]

It reminds of a 5 screw retained implants I did 6 years ago, the dr. tightens the screws by hand without a torquing wrench( as he said by feel) to the point he broke 3 screws. I provided all the information beforehand with the case high lighted in dark pink the correct amount of torque, I have every copy of all correspondence.

 

[Brett Hansen CDT]

We are not being held responsible by the doctor. These are all Straumann parts. I am confident that the doctor torqued this abutment correctly. I have done hundreds of implant cases with him. I am going to charge him our cost for refabricating the abutment and the crown. If this were an Atlantis abutment case, I know they would give me a discount on the second abutment...but then there customer service is excellent and they actually have an interest in helping out the laboratory. I am not expecting Straumann to do anything to help me and the doctor with this case.

 

[corona]

so Brett , are you saying that all straumann parts used , and straumann is NOT helping ? what about their warranty? It seems that is the reason they wanted us to use all parts from their company in the first place . So straumann left the patient , the doctor ,and the lab out in the cold ?

Well at least they bent over backwards to ante up the new impression components . Keep up the good work Straumann.

 

[grantoz]

I love the way the straumann reps run around saying that if we don't use their parts that we void the warranty . Now they are saying after we use their bits we still don't have a warranty what a bunch of slippery snakes. I have never heard a bigger bunch of crap what great guys doing everyone a favour by helping this time please give me a break.I started a thread on this same subject a while ago on straumann,s great warranty.

 

[EJADA]

The doctor should fix the problem for free. The lab should remake it at a discount, and straumann should discount as well.

But that's in a perfect world.

Good luck

 

[sidesh0wb0b]

there are a handful of reasons why a screw would loosen. how deep was the fixture placed? ive seen it where an abutment pinched tissue at the platform and as the tissue disintegrated it left a slight gap, which in turn caused screw loosening....but there are other reasons that could have lead to it.
who should bear the burden of replacement is up to you. if youve done hundreds of implants with no failures for this guy, do what you can to keep him happy. even if it means just charging a small amount, or nothing at all.

 

[EJADA]

To bad the DDS can't charge the patient for it as an MD would. I had a titanium rod placed in my femur sometime back. Surgeon comes in next day and says he has to go back in as th two upper screws missed the titanium rod. (Big oops). I said ok are you going to charge me? He said no, not him but the hospital and anesthesiologist would. Im guessing he was just hoping to not get sued. Maybe we are kind of like the anesthesiologist in this case. ( not likely).

 

[Brett Hansen CDT]

I just talked to the Straumann rep....they are gonna credit our account for the new abutment. This is how business should be done.

 

[PDC]

I just talked to the Straumann rep....they are gonna credit our account for the new abutment. This is how business should be done.

You didn't mention that you were discussing this on DLN with a world-wide audience did you?

 

[Brett Hansen CDT]

I didn't PDC, but I wouldn't be surprised if this thread got noticed. I have gotten a call a from an abutment company thanking me for endorsing their product on this site before. The DLN is an amazing resource for us. I can't imagine how you "older" techs did it before the internet.

 

[Big Guy]

If he's a good account take care of him. Regardless of who's fault it is if it costs you a few bucks and some time to save a good account then it's well worth it. As afar as the screw coming lose I don't think you will ever really know how or why if it continues to happen then worry about it. My $.02