Clinical Innovations/Technique Tips/Techno Transfer

A Simple Technique for Retrieval of Journal of Indian Orthodontic Society

53(3) 211–212, 2019

Fractured Mini-implant © 2019 Indian Orthodontic Society

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DOI: 10.1177/0301574219853723
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Rajiv Ahluwalia1, Shruveta Srivastava1, and Himanshu Garg1

Abstract
There is a plethora of literature available on miniscrew implant placement since they have been used for anchorage since
1997. Inappropriate usage of a micro-implant could lead to the fracture of the micro-implant, but literature has inadequate
documentation probably due to insufficient reporting of these cases. A simple technique for the retrieval of fractured
mini-implant is presented here.

Keywords
Orthodontic implant, anchorage, mini-implant fracture, torque

Introduction 4. With the use of contra-angled micro-motor hand

In contemporary orthodontics, the increased use of mini-
implants is established. Inadvertent and irresponsible use
of micro-implants has highlighted implant fracture as a
major drawback. Fracture of miniscrew implants depends
on the amount of insertion torque during placement.1 It
frequently occurs in the mandible where the cortical bone
density is significantly high, thereby increasing insertion
torque. Accepted torque value of self-drilling mini-implants
is 3-10 N cm.1 Self-drilling screws are ideal for D2 and D3
bone (Misch classification). Although greater anchorage is
achieved when mini-implants are inserted in D1 bone, mini-
implants are more vulnerable to fracture due to increased
resistance by D1 bone.2,3
Simple steps for retrieval are as follows:
1. Patient is informed about mini-implant fracture and
retrieval procedure is also explained.
2. Patient is cleaned and draped, and the area of the
mini-implant fracture is anesthetized locally using
2% lignocaine with adrenaline (1:200 000).
3. After mini-implant fracture, there is usually no
bleeding at the site and the abraded gingiva makes
it difficult to localize the site of implant fracture. To
localize it, a small incision is made at the site with BP
blade no. 15. Sufficient exposure of site is essential
to allow the retrieval procedure (Figure 1[a]).
piece, with tungsten carbide burs (RA#1/4 Round
bur and RA# 700 taper fissure cross cut bur) at low
speed and copious saline irrigation, a circumferential
trough around the implant is created, thereby
loosening it (Figure 1[b]).
5. Care is taken to have a centrifugal force (outward
toward the bone) rather than centripetal (inward
toward the implant), which ensures that the implant
is not thinned down further, which might make it
more prone to fracture.
6. Extent of implant loosening is carefully evaluated
by a thick straight probe after every round of
circumferential bone cutting. Higher forces of
lateral probing may result in implant fracture at
lower length. Once it is sufficiently loosened, the
tip of micro-implant is held with thin artery forceps
and counter clockwise movement is given to loosen
the screw.
7. Fractured implant is removed and sutures are placed
to close the area (Figure 1[c] and Figure 1[d]).
1
Department of Orthodontics and Dentofacial Orthopedics, Santosh
Dental College and hospital, Ghaziabad, Uttar Pradesh, India.
Corresponding author:
Himanshu Garg, Flat No. 501, A Block, Gardenia Square Crossing Republic,
Ghaziabad, Uttar Pradesh 201016, India.
E-mail: himanshugarg913@gmail.com

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8. Post-surgical instructions are given to the patient.
Patient is also prescribed antibiotics and analgesics
for 3 days.
9. To confirm full retrieval, Intra-oral periapical X ray
is taken.
10. Suture removal is done after a week
Figure 1(a). Exposed Site of Fractured Mini-implant
Figure 1(b). Bur Hole Around the Implant Periphery
Figure 1(c). Retrieved Fracture Implant
Journal of Indian Orthodontic Society 53(3)
Figure 1(d). Closed Site with Suture
Conclusion
Miniscrews are valuable tools that increase the quality of
orthodontic treatment if properly used. The orthodontist
should keep in mind the possibility of fracture of the mini-
implant during placement, and the above-mentioned
armamentarium should always be available on the day the
implant placement has to be performed.
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to
the research, authorship, and/or publication of this article.
Funding
The authors received no financial support for the research,
authorship, and/or publication of this article.
References
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anchorage in clinical orthodontics. Japan Dent Sci Rev.
2014;50:79-85.
2. Hutton JE, Heath MR, Chai JY, et al. Factors related to success
and failure rates at 3-year follow-up in a multicenter study
of overdentures supported by branemark implants. Int J Oral
Maxillofac Implants. 1995;10:33-42.
3. Jaffin RA, Berman CL. The excessive loss of branemark fixtures
in type IV bone: a 5-year analysis. J Periodontol. 1991;62:2-4.