
Retrieval of a Cold Welded and Damaged Gingival Former: A Clinical Tip
ZJ01-ZJ02
Correspondence
Unmesh Wani,
1103, Block H, Amit Bloomfield, Ambegaon, Pune-411046, Maharashtra, India.
E-mail: unmesh1996wani@gmail.com
A 62-year-old male patient was referred to the Department of Prosthodontics at Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Pune, Maharashtra, India, for the retrieval of a gingival former in the lower anterior region. An implant from COWELL® Implant Solution was placed in the regions of 33 and 43 at a private clinic approximately 11 months ago. The second stage surgery was performed seven months ago. Two gingival formers with a collar height of 2 mm were placed in the regions of 33 and 43. For the commencement of the prosthetic phase, the gingival formers needed to be removed.
Initially, a hex driver was used for the retrieval of the gingival former. During the removal process, it was noticed that the threads in the access hole of the gingival former in the region of 33 were irreversibly damaged due to excessive torque applied by the previous dentist, which led to cold welding and failure to engage the hex driver. Various methods, such as reverse torquing and ultrasonic retrieval techniques, were attempted but proved ineffective(1).
Using a high-speed handpiece and a carbide bur, a plus-shaped groove approximately 2 mm in depth was created from the center by extending the access hole of the former under copious irrigation until the screwdriver fitted snugly (Table/Fig 1) (2). A high vacuum suction was employed to prevent any particles of the former from being swallowed by the patient. The screwdriver from the Typodont jaw set was autoclaved before use in the patient’s mouth (Table/Fig 2).
The gingival former was modified until the beak of the screwdriver fit snugly into the plus-shaped groove (Table/Fig 3). Utmost care was taken during the grooving process, as excessive removal of the structure could lead to failure in fitting the screwdriver (Table/Fig 4).
The gingival former was modified until the beak of the screwdriver fit snugly into the plus-shaped groove (Table/Fig 3). Careful attention was given during the grooving process, as excessive removal could result in failure to fit the screwdriver properly.
Once the former was retrieved (Table/Fig 4), an implant-level impression was recorded using putty and light body material and a new gingival former was placed (Table/Fig 5). The final prosthesis was delivered to the patient in accordance with the principles of implant-protected occlusion (Table/Fig 6).