Managing a Fractured Prosthetic Screw in All-on-4: Why Experience Matters

When most people think about dental implant complications, they imagine the implant itself failing. In reality, one of the most complex challenges is not the implant, but the fractured prosthetic screw inside a Multi-Unit Abutment (MUA). This is a rare but demanding complication that requires advanced skill and knowledge of the All-on-4 procedure.

The Case: A Fractured Screw That Wouldn’t Budge

A patient came in with a fractured prosthetic screw within the MUA of their All-on-4 dental bridge. Normally, this is managed with specialised tools such as an emergency screw removal kit. However, in this case, the kit was unsuccessful — the broken screw fragment was lodged deep and immovable.

At first glance, some might assume the only option is to remove the entire implant. But with experience and precision, that isn’t necessary.

The Solution: Cutting Through to Restore Function

In this case, we carried out a careful step-by-step approach:

• The coronal portion of the MUA was cut to access the broken fragment.

• The flat thread of the screw was cut into, freeing the fractured segment.

• Once the fragment was removed, a new MUA was torqued to 20N.

• The bridge was repositioned securely, restoring full function.

The patient walked away with their implants intact and their smile restored — without the need for additional surgery.

Key Lesson: Not Every Prosthetic Fracture Means Implant Removal

The underlying message here is simple:

• A fractured prosthetic screw does not mean implant failure.

• With the right expertise, the problem can be resolved while preserving the implants.

• Patients benefit from faster recovery, fewer procedures, and reduced cost.

  
  

Why Choose an Experienced Dentist for All-on-4

The All-on-4 dental implant procedure is life-changing, but it is also intricate. Managing complications such as fractured prosthetic screws requires advanced knowledge of both the surgical and prosthetic aspects of implant dentistry. An experienced dentist can often save implants that might otherwise have been unnecessarily removed.

If you are facing complications with your All-on-4 bridge, don’t assume you have to start over. Seek care from a dental surgeon who understands the full complexity of this treatment. With the right hands, your implants — and your confidence — can be preserved.