FDA Adverse Event Injury Summary report: N

S ATLANTIS ABUTM GOLDSHADED TI

MDR report key: 23402624 · Received October 28, 2025

Report

Report Number
1222802-2025-00029
Event Type
Injury
Date Received
October 28, 2025
Report Date
October 28, 2025
Manufacturer
DENTSPLY IH INC.
Product Code
NHA
UDI-DI
07392532083440
PMA / PMN Number
MULTIPLE
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
DENTIST
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THEREFORE, BECAUSE A SERIOUS INJURY RESULTED, THIS EVENT IS REPORTABLE PER 21 CFR PART 803. SECTION H6 WAS DONE BASED ON THE INFORMATION PROVIDED BY THE INITIAL REPORTER AND OUR LONG-TIME EXPERIENCE IN THE INVESTIGATION OF SIMILAR COMPLAINTS. PRODUCT RETURN IS REQUESTED AND PRODUCT WILL BE EVALUATED AFTER RECEIPT. IN CASE ANY NEW OR ADDITIONAL INFORMATION WILL BE GAINED FROM THIS INVESTIGATION A FOLLOW-UP REPORT WILL BE SENT. TREND IS TRACKED AND MONITORED.

Description of Event or Problem · 0

IT WAS REPORTED THAT A PATIENT EXPERIENCED A DENTAL ATLANTIS ABUTMENT SCREW BREAKAGE. THE BROKEN PIECE COULD NOT BE RETRIEVED AND THE STRAUMANN DENTAL IMPLANT HAD TO BE EXPLANTED AS A RESULT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2353173 S ATLANTIS ABUTM GOLDSHADED TI ABUTMENT, IMPLANT, DENTAL, ENDOSSEOUS NHA DENTSPLY IH INC. 07392532083440

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Required Intervention