Do I Need to Remove My Dental Implant Screws? Expert Insights

The fixed dentures need to be completely redone?

A few days ago, I noticed that my dentures didn't fit properly and had gaps, so I went to another dentist.
He removed my dentures and examined the condition of my teeth, also taking X-rays.
I have four front teeth that are connected with a dental bridge.
The dentist said that one tooth has been extracted while the other has not.
The two extracted teeth have dental posts, but one of the posts was placed by a previous dentist about 10 years ago.
The new dentist mentioned that one of my front teeth with a post is inflamed, and the posts have become loose.
Additionally, the other two teeth need root canal treatment, so everything needs to be redone.

Later, I received a temporary dental crown, but every time he removes it, the tooth that has undergone root canal treatment and has a post hurts.
Recently, he said he needs to remove the post, and I'm very worried about whether the tooth root will fracture.
However, the dentist took X-rays and said that my tooth root is still quite healthy and that the tooth with the temporary crown is not inflamed, and the nerve has been cleaned out properly.
Doctor, should I go ahead and have the post removed? I'm really afraid that removing the post will cause the tooth root to fracture and lead to tooth extraction.

Ya Ya, 20~29 year old female. Ask Date: 2015/07/14

Dr. Zhang Xiangyuan reply Dentistry

Dear netizen,
According to your description, the dentist has recommended removing the root post to facilitate re-treatment.
However, you are concerned about the possibility of the root fracturing and the need for extraction.
While individual tooth conditions vary, there are inherent risks associated with any treatment.
Removing the root post sometimes carries the risk of root fracture.
It is believed that the dentist treating you will also assess the related risks.
If you remain very concerned, it is advisable to discuss with your dentist whether there are alternative treatment options and recommendations, as well as the differences in subsequent prognosis.
You can carefully consider and evaluate before making a decision.
Thank you for your inquiry.

Reply Date: 2015/07/14

More Info

When it comes to dental implants and the associated screws, your concerns are valid and common among patients undergoing similar treatments. Based on your description, it seems that you have a complex dental history involving multiple treatments, including root canals and the placement of dental implants. Here’s a detailed breakdown of your situation and the considerations regarding whether or not to remove the dental implant screws.

Understanding Your Situation
1. Dental Implants and Screws: Dental implants consist of a titanium post (the screw) that is surgically placed into the jawbone to serve as a replacement root for a missing tooth. Over time, the bone integrates with the implant in a process called osseointegration. If the implant is functioning well and there are no signs of infection or bone loss, the screws typically do not need to be removed.

2. Signs of Infection or Failure: You mentioned that one of your implants has become inflamed and that the screws are loose. This could indicate a few things:
- Peri-implantitis: This is an inflammatory condition affecting the soft and hard tissues surrounding the implant. It can lead to bone loss and may require treatment.

- Mechanical Failure: Loose screws can be a sign of mechanical failure, which might necessitate the removal of the screws or the entire implant.

3. Pain and Sensitivity: The pain you experience when the temporary crown is removed could be due to several factors, including inflammation, pressure on the surrounding tissues, or sensitivity from the underlying tooth structure. If the tooth has undergone root canal treatment, it may still be sensitive, especially if the crown is not properly fitted.

Should You Remove the Screws?
1. Consultation with Your Dentist: The first step is to have a thorough discussion with your dentist about the necessity of removing the screws. If the X-rays show that your dental roots are healthy and there is no significant bone loss or infection, it may not be necessary to remove the screws. However, if there is evidence of infection or if the screws are indeed loose, removal might be warranted.

2. Risks of Removal: You expressed concern about the risk of fracturing the dental root during the removal process. While this is a valid concern, experienced dentists typically take precautions to minimize this risk. If the root is healthy, the chances of it fracturing during screw removal are relatively low, but it is not impossible.

3. Alternative Treatments: If the screws need to be removed due to infection or mechanical failure, your dentist may discuss alternative treatments. This could include:
- Re-implantation: If the implant site is healthy, a new implant can be placed after the old one is removed.

- Bone Grafting: If there has been bone loss, a bone graft may be necessary before placing a new implant.

4. Temporary Solutions: In the meantime, if you are experiencing discomfort, your dentist may provide a temporary solution to alleviate pain and protect the area until a definitive treatment plan is established.

Conclusion
In summary, whether or not to remove your dental implant screws depends on the health of the surrounding tissues, the stability of the screws, and the presence of any infection. It is crucial to maintain open communication with your dental care provider, who can guide you through the decision-making process based on your specific circumstances. Regular follow-ups and monitoring will also be essential to ensure the long-term success of your dental treatments. Remember, addressing any issues early on can prevent more significant complications down the line.

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