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 |