Likes : 2

Ho-Young Chung Replied at Mon, May 8, 2017 10:05 AM

Hi Anand,

I get a feeling that you tried using an RP driver to remove this 3.5 fixture.  The mini implant driver in HiOssen kit is the 3.5 fixture driver.  Has there been a mesial tilt of tooth 36?  I'm not sure whether there is enough space for a crown with adequate emergence profile for this edentulous space.  Also, before removing this implant, I would suggest checking to make sure that an impression coping will come through the edentulous space so that you know that a replacement implant can be restored.  I have little experience with Invisilign treatment but ideally, the 36 should be distalized (not sure whether Invisilign can do that).  

your 35 implant placement/position is good.  It's the lack of space that is a concern to me.  

You may need fixture removal tool, however, as the fixture can fracture (especially NP platform for any implant company) if you try to reverse torque it using just the fixture driver (depending on how well it is integrated and how much torque you need to apply).  When using fixture driver only to remove an integrated implant, the fixture can either flower or crack depending on the grade of titanium or titanium alloy.  fixture removal tools have a core screw that engages the internal structure then a removal tool can be used to "wrap" around the external walls of the implant to reverse torque the fixture without "popping" the fixture from the inside.  

However, sometimes you have to resort to more "traumatic" methods in order to remove a fixture.  fixture removal tool is the ideal choice but sometimes you have to sacrifice the buccal plate in order to remove an implant.  

Ho-Young Chung