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An Y, Xie L, Liu Y, Wu P, Li H, Jiang J, Zhang Z, Yang S. Research on skull trauma biomechanical stress distribution in case of dental implants existence. Technol Health Care 2022; 31:821-829. [PMID: 36442219 DOI: 10.3233/thc-220148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND: When the jaw bone is subjected to an external force, the stress is transmitted from the force point along the alveolar bone to the skull and skull base. In the case of a dental implant, the stress distribution is mainly dependent on the implant position, type, and mechanical properties. OBJECTIVE: To investigate the dental implant position influence on the stress distribution and transmission in case of facial frontal trauma. Furthermore, the correlation between facial trauma and skull trauma in the case of a dental implant exists. METHODS: In this study, a Finite Element Method (FEM) model was constructed based on a real skull shape, size, and anatomy. Dental implants were modeled based on imported CAD Data. Five cases were investigated including no dental implant and the replacement of teeth no. 18, 19 20 and 21. Facial trauma was mimicked by applying an external load on the lower frontal jaw. Finally, the stress distribution based on the bone geometry and implant position were evaluated and compared. RESULTS: Results suggested that a dental implant could significantly influence the stress distribution in the skull in case of facial trauma. In addition, the dental position greatly affects stress transmission from the mandible to the skull bones through the zygomatic arch. CONCLUSION: The position of the dental implant could have a significant role in stress transmission and distribution in case of facial or even brain trauma. Thus, increasing the possibility of a correlation between facial and brain trauma.
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Affiliation(s)
- Yang An
- General Hospital of the Western War Zone of the Chinese People’s Liberation Army, Chengdu, Sichuan, China
- General Hospital of the Western War Zone of the Chinese People’s Liberation Army, Chengdu, Sichuan, China
| | - Ling Xie
- Department of Stomatology, People’s Hospital of Tianfu New District, Chengdu, Sichuan, China
- General Hospital of the Western War Zone of the Chinese People’s Liberation Army, Chengdu, Sichuan, China
| | - Yu Liu
- General Hospital of the Western War Zone of the Chinese People’s Liberation Army, Chengdu, Sichuan, China
| | - Po Wu
- Department of Stomatology, People’s Hospital of Tianfu New District, Chengdu, Sichuan, China
| | - Hao Li
- General Hospital of the Western War Zone of the Chinese People’s Liberation Army, Chengdu, Sichuan, China
| | - Ji Jiang
- General Hospital of the Western War Zone of the Chinese People’s Liberation Army, Chengdu, Sichuan, China
| | - Zhengrui Zhang
- General Hospital of the Western War Zone of the Chinese People’s Liberation Army, Chengdu, Sichuan, China
| | - Shuyong Yang
- General Hospital of the Western War Zone of the Chinese People’s Liberation Army, Chengdu, Sichuan, China
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Goiato MC, Andreotti AM, dos Santos DM, Nobrega AS, de Caxias FP, Bannwart LC. Influence of length, diameter and position of the implant in its fracture incidence: A Systematic Review. J Dent Res Dent Clin Dent Prospects 2019; 13:109-116. [PMID: 31592306 PMCID: PMC6773918 DOI: 10.15171/joddd.2019.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 07/02/2019] [Indexed: 11/29/2022] Open
Abstract
Background. Implant fractures can cause difficult problems for patients and dentists. This systematic review aimed to determine the influence of some implant parameters on the occurrence of their fracture and to determine the incidence of fractures reported in recent years.
Methods. A search was conducted in Pubmed database, from which 12 studies published in the last 12 years were selected.
Results. This review reported a 2% incidence of implant fracture. Most implants had been in function between 3 and 4 years until fracture. The studies did not provide necessary information to establish a relationship between the different parameters of implants and the incidence of fractures.
Conclusion. Thus, the indication of type, diameter and length of an implant and the bone quality in the region receiving it should be studied and accurately examined for each individual case in order to avoid future failures.
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Affiliation(s)
- Marcelo Coelho Goiato
- Professor, Department of Dental Materials and Prosthodontics; Araçatuba Dental School, São Paulo State University Júlio de Mesquita Filho, UNESP, Araçatuba, Brazil
| | - Agda Marobo Andreotti
- PhD Student; Department of Dental Materials and Prosthodontics; Araçatuba Dental School, São Paulo State University Júlio de Mesquita Filho, UNESP, Araçatuba, Brazi
| | | | - Adhara Smith Nobrega
- PhD Student; Department of Dental Materials and Prosthodontics; Araçatuba Dental School, São Paulo State University Júlio de Mesquita Filho, UNESP, Araçatuba, Brazi
| | - Fernanda Pereira de Caxias
- PhD Student; Department of Dental Materials and Prosthodontics; Araçatuba Dental School, São Paulo State University Júlio de Mesquita Filho, UNESP, Araçatuba, Brazi
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Gupta S, Gupta H, Tandan A. Technical complications of implant-causes and management: A comprehensive review. Natl J Maxillofac Surg 2015; 6:3-8. [PMID: 26668445 PMCID: PMC4668729 DOI: 10.4103/0975-5950.168233] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Given the increasing popularity of dental implants, the number of failures due to late implant fracture is also expected to increase. Hence, the scope for prevention and management needs to be emphasized. The objective of this review article is to analyze the various causes of failure of dental implants due to implant fixture/abutment screw fractures and also to enumerate the management and the preventive options for these failures, thereby aiming to help the clinicians to properly plan the implant-supported prosthesis treatment by considering the important biomechanical aspects of this type of rehabilitation. The present review emphasizes the causes and management of technical complications and not the incidence of such complications.
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Affiliation(s)
- Swati Gupta
- Department of Prosthodontics, Babu Banarasi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India
| | - Hemant Gupta
- Department of Oral and Maxillofacial Surgery, Babu Banarasi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India
| | - Amrit Tandan
- Department of Prosthodontics, Babu Banarasi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India
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Oh SL, Barnes D. Managing a fractured implant: A clinical report. J Prosthet Dent 2015; 115:397-401. [PMID: 26581662 DOI: 10.1016/j.prosdent.2015.08.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 08/24/2015] [Accepted: 08/26/2015] [Indexed: 11/26/2022]
Abstract
Implant fixture fracture is one of the reasons for late implant failure, with incidence rates ranging from 0.2% to 7.5%. Material defects, occlusal overload, prosthetic design, and nonpassive prosthesis fit have been identified as causative factors for implant fixture fractures. A custom-made prosthetic post was made to connect the remaining implant fixture and the implant-retained crown, as the fractured implant fixture exhibited no signs of infection and the fixture had adequate remaining length. In addition, complete removal of the implant could have resulted in significant bone loss at the site.
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Affiliation(s)
- Se-Lim Oh
- Assistant Professor, Department of Periodontics, University of Maryland, School of Dentistry, Baltimore, Md.
| | - Douglas Barnes
- Professor, Department of General Dentistry, University of Maryland, School of Dentistry, Baltimore, Md
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Marcelo CG, Filié Haddad M, Gennari Filho H, Marcelo Ribeiro Villa L, Dos Santos DM, Aldiéris AP. Dental implant fractures - aetiology, treatment and case report. J Clin Diagn Res 2014; 8:300-4. [PMID: 24783165 DOI: 10.7860/jcdr/2014/8074.4158] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 01/25/2014] [Indexed: 12/28/2022]
Abstract
PURPOSE This study aimed to investigate the etiology, clinical manifestations, and treatment options of dental implants fractures through a literature review and to relate a clinical report. METHODS A literature review was performed using the Medline database and this paper describes a case demonstrating the management of implant fracture. Twenty two articles were selected in the present literature review. RESULTS Nowadays the use of dental implants to rehabilitate completely and partially edentulous patients became the best treatment option; however, this treatment is suitable to failure. The fracture of implant body is a possible complication. The fracture of implant body is a late complication and is related to the failure in implant design or material, non-passive fitting of the prosthetic crown and overloading. Clinically, prosthesis instability and spontaneous bleeding are observed. Three options of treatment have been indicated: complete removal of implant fragment, maintenance of implant fragment, and surface preparation of the fragment with insertion of a new abutment. CONCLUSION The literature indicates the complete removal of the fragment as the best treatment option.
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Affiliation(s)
- Coelho Goiato Marcelo
- Professor, Department of Dental Matherials and Prosthodontics, Araçatuba Dental School, São Paulo State University , Araçatuba, Sao Paulo, Brazil
| | - Marcela Filié Haddad
- Student, Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State University , Araçatuba, Sao Paulo, Brazil
| | - Humberto Gennari Filho
- Professor, Department of Dental Matherials and Prosthodontics, Araçatuba Dental School, São Paulo State University , Araçatuba, Sao Paulo, Brazil
| | - Luiz Marcelo Ribeiro Villa
- Student, Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State University , Araçatuba, Sao Paulo, Brazil
| | - Daniela Micheline Dos Santos
- Professor, Department of Dental Matherials and Prosthodontics, Araçatuba Dental School, São Paulo State University , Araçatuba, Sao Paulo, Brazil
| | - Alves Pesqueira Aldiéris
- Student, Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State University , Araçatuba, Sao Paulo, Brazil
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SEM Analysis and Management of Fracture Dental Implant. Case Rep Dent 2013; 2013:270385. [PMID: 23710372 PMCID: PMC3655462 DOI: 10.1155/2013/270385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Accepted: 04/01/2013] [Indexed: 11/18/2022] Open
Abstract
Implant fracture is one of the important biomechanical complications which can present with a considerable problem to the patient as well as the dental surgeon. The aim of this case report is to describe the management of a case of fractured endosseous dental implant in premolar region and microscopic evaluation of the fractured implant segment using scanning electron microscopy. In most of such cases, complete removal of the fractured implant has been a preferred treatment option. In the present case, fractured implant segment was successfully removed and rehabilitated immediately with larger diameter implant. It was found that retrieved fracture segment had a diameter of 3.3 mm, and SEM analysis shows fatigue fractures which may be the result of excessive overloading and use of small diameter implant which enhances fatigue failure.
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Abstract
Dental trauma can result in tooth loss despite best efforts at retaining and maintaining compromised teeth (Dent Traumatol, 24, 2008, 379). Upper anterior teeth are more likely to suffer from trauma, and their loss can result in significant aesthetic and functional problems that can be difficult to manage (Endod Dent Traumatol, 9, 1993, 61; Int Dent J 59, 2009, 127). Indeed, teeth of poor prognosis may not only present with compromised structure but trauma may also result in damage to the support tissues. Injury to the periodontium and alveolus can have repercussions on subsequent restorative procedures (Fig. 19). Where teeth are identified as having a hopeless prognosis either soon after the incident or at delayed presentation; planning for eventual tooth loss and replacement can begin at the early stages. With advances in both adhesive and osseointegration technologies, there are now a variety of options for the restoration of edentate spaces subsequent to dental trauma. This review aims to identify key challenges in the provision of tooth replacement in the traumatized dentition and outline contemporary methods in treatment delivery.
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Affiliation(s)
- Aws Alani
- Department of Restorative Dentistry, Newcastle Dental Hospital, Newcastle, UK
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den Hartog L, Meijer HJA, Stellingsma K, Santing HJ, Raghoebar GM. Trauma to an implant-supported crown that was saved by the fixation screw: a case report. Dent Traumatol 2010; 26:366-9. [PMID: 20497448 DOI: 10.1111/j.1600-9657.2010.00898.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A traumatic impact to an implant-supported crown might damage the implant, restoration and peri-implant tissues. Ideally, only a small prosthetic retreatment is needed for restoration, as complicated prosthetic retreatments or surgical retreatments in particular, could be very inconvenient for the patient. However, there is a deficiency in literature on how the implant, restoration and surrounding tissues generally react to impact forces. This report demonstrates a case of trauma to an implant-supported crown in the maxillary anterior zone resulting in a displacement of the implant crown. After careful examination and follow-up, it appeared that only the fixation screw was damaged, whereas the implant, restoration and peri-implant tissues remained unharmed. Thanks to the protective qualities of the implant system, an easy prosthetic retreatment could restore the implant-supported crown and a surgical retreatment was prevented.
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Affiliation(s)
- Laurens den Hartog
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, The Netherlands.
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Glendor U. Epidemiology of traumatic dental injuries - a 12 year review of the literature. Dent Traumatol 2008; 24:603-11. [DOI: 10.1111/j.1600-9657.2008.00696.x] [Citation(s) in RCA: 334] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Oelgiesser D, Levin L, Elpeleg O, Schwartz-Arad D. Posttraumatic dental implant placement in a patient with maple syrup urine disease. IMPLANT DENT 2006; 15:143-7. [PMID: 16766896 DOI: 10.1097/01.id.0000217804.27011.75] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Maple syrup urine disease (MSUD) is an inborn error of metabolism resulting from a defect in the oxidation of the branched-chain amino acids leucine, isoleucine, and valine. Patients present in early infancy with brain edema; delay in diagnosis and treatment is common and associated with residual neurologic damage, which includes alternating muscular hypotonia and hypertonia, dystonia, and seizures. These signs can result in trauma, especially to the anterior maxilla, which is the most traumatized region. In patients with MSUD, a fixed prosthesis is recommended because a removable one can be dangerous because of the risk of aspiration. Rehabilitation, using dental implants, is especially challenging in these patients because of the strong muscular forces of the tongue and lips. An implant-supported fixed prosthesis might provide an effective functional, esthetic, and predictable solution for patients with late-treated MSUD. The present report describes a 10-year follow-up of the successful, posttraumatic use of a dental implant to replace an anterior maxillary tooth in a patient with MSUD.
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Affiliation(s)
- Dan Oelgiesser
- Department of Periodontology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Israel
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Abstract
Single tooth implant systems have been shown to offer a safe and highly predictable option for the replacement of anterior teeth. There is however, a paucity of evidence on the result of trauma to single tooth implant systems, particularly in the vulnerable anterior maxillary area. This article presents a report on the outcome of a traumatic incident to an osseointegrated single tooth implant.
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Affiliation(s)
- Edith M Allen
- Department of Restorative Dentistry, University College Dental School and Hospital, Wilton, Cork, Ireland.
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Pérez del Palomar A, Arruga A, Cegoñino J, Doblaré M. A finite element comparison between the mechanical behaviour of rigid and resilient oral implants with respect to immediate loading. Comput Methods Biomech Biomed Engin 2005; 8:45-57. [PMID: 16154870 DOI: 10.1080/10255840500141593] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
In this paper, a qualitative comparison between two types of dental implants with respect to their behaviour under immediate loading is presented. This analysis has been carried out using the finite element method. Since micromotions (and not the load) are responsible of the appearance of a fibrous interface avoiding osseointegration, the relative displacement between the bone surface and the implant has been the main variable analyzed at different loading states and for the two implant types here considered. The implants analyzed differ in their mechanical behavior: rigid or resilient. Their main difference lies in the joining between the different pieces that make up the dental system. While in the rigid implant all the pieces are screwed, in the resilient implant a relative displacement between the pieces is allowed, with the additional introduction of a silicone gasket that acts like the periodontal ligament. Both implants were considered with a similar geometry and under two different loading scenarios, one equivalent to the force of chewing applied to a molar and another which corresponds to a premolar. For the resilient implant, a hyperelastic behaviour for the silicone and contact conditions between the different mobile parts of the implant are considered. The displacements of the emerging-body in both designs are also compared with the values obtained by several authors. However, the results show that both implants fulfill the constraint of the immediate loading protocol. The micromotions of the resilient implant are lower to those of the rigid one, favouring therefore a good osseointegration process while keeping the stresses in the implant under admissible maximum values.
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Affiliation(s)
- Amaya Pérez del Palomar
- Group of Structural Mechanics and Materials Modeling, Aragón Institute of Engineering Research, University of Zaragoza, Spain.
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