Atraumatic Retrieval of a Fractured Implant Screw in a Maxillary Locator-Retained Overdenture: A Longitudinal Case Report

Fracture of implant prosthetic screws is a significant mechanical complication that may compromise implant stability, prosthetic function, and long-term restorative success. Retrieval of fractured screw fragments can be particularly challenging in implant overdenture patients because of limited access, prosthetic wear, and the risk of damaging the implant’s internal connection during retrieval procedures. This report describes the conservative management of a fractured implant screw associated with a maxillary locator-retained overdenture in a medically compromised elderly patient with a prolonged history of prosthetic maintenance complications. A 67-year-old female patient with a history of diabetes mellitus, heavy smoking, poor oral hygiene, and long-term implant overdenture therapy underwent staged maxillary and mandibular implant rehabilitation. Over several years of follow-up, repeated prosthetic complications were documented, including overdenture instability, worn locator attachments, recurrent retention loss, relining procedures, soft tissue overgrowth, and ongoing prosthetic adjustments. The patient subsequently presented with a fracture of a prosthetic screw associated with the maxillary overdenture attachment system. Following prosthetic disassembly and conservative soft tissue exposure using a laser-assisted approach, the fractured screw fragment was mobilized using ultrasonic instrumentation in a counterclockwise direction. A flexible adhesive-assisted retrieval technique was then utilized to atraumatically engage and remove the fractured fragment while minimizing the risk of damage to the implant’s internal threads and connection. The fractured fragment was successfully retrieved without complications, and the implant remained intact and functional without the need for implant removal or aggressive surgical intervention. This case highlights the biomechanical and maintenance-related challenges associated with long-term implant overdenture therapy in medically compromised patients and demonstrates the clinical usefulness of minimally invasive screw retrieval techniques for preservation of implant function and prosthetic continuity.