Análisis comparativo de la recuperabilidad y el daño de la conexión implante-pilar de tornillos de pilar fracturados utilizando técnicas convencionales y guiadas

Abstract

[ES] Este estudio tuvo como objetivo evaluar la capacidad de recuperación y el posible daño en las conexiones implante-pilar ocasionado por la extracción de torni-llos de pilar fracturados mediante técnicas convencionales y de fresado. Se frac-turaron y extrajeron cuarenta tornillos insertados en implantes dentales utilizando cuatro métodos: convencional con sonda exploradora y dispositivo ultrasónico (Grupo A), sistema de fresado Phibo (Grupo B), sistema Rhein83® (Grupo C) y sistema Sanhigia® (Grupo D), todos sin irrigación. Se realizaron escaneos micro-CT antes y después de los procedimientos, generando archivos STL para el aná-lisis morfométrico del volumen de desgaste. El análisis estadístico (ANOVA) no mostró diferencias significativas en el volumen ni en el porcentaje de desgaste de las roscas internas entre los grupos, aunque la tasa de éxito en la recupera-ción de tornillos fue mayor con los sistemas de fresado (90%) frente a la técnica convencional (50%). Estos resultados sugieren que los sistemas de fresado son más eficaces para la extracción de tornillos dañados, sin que ello implique un mayor desgaste en la conexión implante-pilar.

[EN] This study aimed to evaluate the retrievability and potential damage to implant-abutment connections caused by fractured abutment screw removal using con-ventional and drilling techniques. A total of forty abutment screws were randomly inserted into forty dental implants, then fractured and extracted using different removal methods: Group A employed a conventional approach utilizing an explo-ration probe and ultrasonic device without irrigation (n = 10) (Conventional); Group B used the Phibo drilling removal system without irrigation (n = 10) (Phibo); Group C utilized the Rhein83® drilling removal system without irrigation (n = 10) (Rhein83); and Group D implemented the Sanhigia® drilling removal system with-out irrigation (n = 10) (Sanhigia). Preoperative and postoperative micro-computed tomography (micro-CT) scans were performed on the dental implants, and Stand-ard Tessellation Language (STL) digital files were generated using morphometric analysis to measure wear volume. ANOVA statistical analysis was used to assess volumetric differences (mm³) and percentage ratios between the internal thread volumes of implant-abutment connections before and after the procedures. Re-sults: The study demonstrated no statistically significant differences in volumetric and percentage variations of internal threads among implant groups (Phibo, Rhein83, Sanhigia, and UT). However, the success rate for retrieving fractured abutment screws was higher (90%) with drilling systems compared to the con-ventional technique (50%). These results suggest that drilling systems are more effective for the retrieval of damaged screws. Although drilling techniques without irrigation demonstrated higher removal efficiency compared to conventional methods, both approaches resulted in similar wear volumes on the implant-abut-ment connections when extracting fractured screws.