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Fujii Y, Hatori A, Minami S, Kanno Y, Hamada H, Miyazawa T, Chikazu D. Characteristics and Risk Factors for the Fracture of One-Piece Implants. J Maxillofac Oral Surg 2023; 22:1091-1098. [PMID: 38105858 PMCID: PMC10719176 DOI: 10.1007/s12663-023-02033-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 10/16/2023] [Indexed: 12/19/2023] Open
Abstract
Objective The one-piece dental implant was originally designed to overcome the structural weaknesses of the two-piece implant. However, a fractured one-piece implant requires removal because the abutment cannot be repaired or replaced to support new prosthetic restorations. The aim of this study was to clarify the features and risk factors for fracture of the one-piece implant. Methods This study was designed as a retrospective case series research. The subjects were patients who were treated for fractures of the one-piece implant at a clinic in Japan between 2012 and 2021. Fractures of the one-piece implant were diagnosed by cone-beam computed tomography, and the association between age and duration from implant placement to fracture was analyzed by one-way ANOVA followed by the Tukey test. Results Eighteen patients and 20 one-piece implants (under 39 years: 5 patients and 6 implants; 40-59 years: 7 patients and 7 implants; over 60 years: 6 patients and 7 implants) had fractures in their one-piece implants. Of the fractured implants, 11 had a diameter of 3 mm, and 9 had a diameter of 4 mm. The mean durations up to implant fracture were 662 days in the younger group, 1467 days in the middle group, and 1239 days in older group, and the duration was significantly shorter in the younger group. In addition, 83.3% of fracture implants in the younger group were in the molar region. All fractures of the one-piece implants occurred under the bone margin. Two patients had torus mandibularis, and 1 patient was had bruxism. Conclusions One-piece implants in younger patients that are located in the lower molar position are the most susceptible to implant fracture, and the fracture occurred under the bone margin in all cases.
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Affiliation(s)
- Yasuyuki Fujii
- Department of Oral and Maxillofacial Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, Japan
- Tokyo Ekimae Dental Clinic, 3-3-11 Kyobashi, Chuo-Ku, Tokyo, Japan
| | - Ayano Hatori
- Department of Oral and Maxillofacial Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, Japan
| | - Sakura Minami
- Department of Oral and Maxillofacial Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, Japan
| | - Yuki Kanno
- Tokyo Ekimae Dental Clinic, 3-3-11 Kyobashi, Chuo-Ku, Tokyo, Japan
- Department of Oral and Maxillofacial Surgery, Tokyo Women’s Medical University, 8-1 Kawada-Cho, Shinjuku-Ku, Tokyo, Japan
| | - Hayato Hamada
- Department of Oral and Maxillofacial Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, Japan
| | | | - Daichi Chikazu
- Department of Oral and Maxillofacial Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, Japan
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Saito MM, Onuma K, Yamakoshi Y. Cementum is key to periodontal tissue regeneration: A review on apatite microstructures for creation of novel cementum-based dental implants. Genesis 2023; 61:e23514. [PMID: 37067171 DOI: 10.1002/dvg.23514] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 01/16/2023] [Accepted: 02/05/2023] [Indexed: 04/18/2023]
Abstract
The cementum is the outermost layer of hard tissue covering the dentin within the root portion of the teeth. It is the only hard tissue with a specialized structure and function that forms a part of both the teeth and periodontal tissue. As such, cementum is believed to be critical for periodontal tissue regeneration. In this review, we discuss the function and histological structure of the cementum to promote crystal engineering with a biochemical approach in cementum regenerative medicine. We review the microstructure of enamel and bone while discussing the mechanism underlying apatite crystal formation to infer the morphology of cementum apatite crystals and their complex structure with collagen fibers. Finally, the limitations of the current dental implant treatments in clinical practice are explored from the perspective of periodontal tissue regeneration. We anticipate the possibility of advancing periodontal tissue regenerative medicine via cementum regeneration using a combination of material science and biochemical methods.
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Affiliation(s)
- Mari M Saito
- Department of Biochemistry and Molecular Biology, School of Dental Medicine, Tsurumi University, Yokohama, Japan
| | - Kazuo Onuma
- Department of Biochemistry and Molecular Biology, School of Dental Medicine, Tsurumi University, Yokohama, Japan
| | - Yasuo Yamakoshi
- Department of Biochemistry and Molecular Biology, School of Dental Medicine, Tsurumi University, Yokohama, Japan
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Nikellis T, Lampraki E, Romeo D, Tsigarida A, Barmak AB, Malamou C, Ercoli C, Papaspyridakos P, Kotsailidi EA, Chochlidakis K. Survival rates, patient satisfaction, and prosthetic complications of implant fixed complete dental prostheses: a 12-month prospective study. J Prosthodont 2023; 32:214-220. [PMID: 35964246 DOI: 10.1111/jopr.13593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 08/07/2022] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To determine the survival rate, incidence of prosthetic complications, and patient satisfaction of implant fixed complete dental prostheses (IFCDPs) after a mean observation period of 1.4 years. MATERIALS AND METHODS Twenty-eight (28) eligible participants were recruited according to specific inclusion and exclusion criteria. The definitive metal-acrylic resin IFCDPs consisted of titanium bars veneered with acrylic resin and acrylic denture teeth. Prosthodontic complications, divided into major and minor, were monitored. Parameters such as gender, jaw location, bruxism, and occlusal scheme were evaluated. Moreover, a questionnaire was administered throughout the study to assess patient satisfaction. Poisson regression as well as repeated measures ANOVA were used for statistical analysis. RESULTS Fourteen (14) males and 14 females were enrolled and followed-up at 3, 6, and 12 months. All IFCDPs survived (100% survival rate). The most frequent minor complication was the loss of material used to close the screw access hole (20% out of total complications). The most frequent major complication was chipping of the acrylic denture teeth (77.14% out of total complications). Gender (p = 0.008) and bruxism (p = 0.030) were significant predictors for the total major complications (major wear and major chipping) while occlusal scheme was a significant predictor for major chipping events (p = 0.030). CONCLUSIONS While IFCDPs demonstrated high prosthetic survival rates, they also exhibited a high number of chipping events of the acrylic veneering material, especially in males, bruxers, and individuals with canine guidance occlusion. However, the occurrence of these prosthetic complications did not negatively affect patient satisfaction.
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Affiliation(s)
| | | | - Davide Romeo
- Eastman Institute for Oral Health, University of Rochester, Rochester, NY.,Advanced Oral Surgery Unit, Vita Salute University, San Raffaele Hospital, Milan, Italy
| | - Alexandra Tsigarida
- Department of Periodontology, Eastman Institute for Oral Health, University of Rochester, Rochester, NY
| | - Abdul Basir Barmak
- Eastman Institute for Oral Health, University of Rochester, Rochester, NY
| | | | - Carlo Ercoli
- Department of Periodontology, Eastman Institute for Oral Health, University of Rochester, Rochester, NY
| | - Panos Papaspyridakos
- Department of Periodontology, Eastman Institute for Oral Health, University of Rochester, Rochester, NY.,Department of Prosthodontics, Tufts School of Dental Medicine, Boston, MA
| | - Elli Anna Kotsailidi
- Department of Periodontology, Eastman Institute for Oral Health, University of Rochester, Rochester, NY
| | - Konstantinos Chochlidakis
- Department of Periodontology, Eastman Institute for Oral Health, University of Rochester, Rochester, NY
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Yang F, Ruan Y, Liu Y, Chen J, Chen Y, Zhang W, Ding Y, Wang L. Abutment mechanical complications of a Morse taper connection implant system: A 1- to 9-year retrospective study. Clin Implant Dent Relat Res 2022; 24:683-695. [PMID: 35791805 PMCID: PMC9796380 DOI: 10.1111/cid.13115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 04/29/2022] [Accepted: 05/30/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND The fracture of a Morse tapered abutment connection in an osseointegrated implant is one of the most serious mechanical complications, and it is extremely hard to deal with this complication in clinical practice. PURPOSE The aim of this study was to explore the cumulative mechanical complications focus on abutment of a platform switching Morse taper connection implant system after loading, and to perform a retrospective, approximately 1- to 9-year follow-up study to identify the predisposing factors. MATERIALS AND METHODS A total of 495 patients with 945 fitted implants were enrolled in this study with a follow-up from January 2012 to January 2020. The data of mechanical complications of the abutment, including abutment fracture (AF) and abutment screw loosening (ASL), and possible causative factors were extracted and evaluated statistically. RESULTS A total of 25 out of 945 (2.65%) cumulative abutment mechanical complications occurred. AF was the most common complication (n = 13, 1.38%), followed by ASL (n = 12, 1.27%). For AF, gender, type of prosthesis, abutment design, and implant diameter were identified as the causative factors. AF was mostly observed in the single crown of males in molar areas, while ASL was more likely to occur on an angled abutment than on a non-angled abutment. Moreover, the abutment with the positioning index (/X) had a higher incidence of fracture than the abutment without the positioning index (C/). CONCLUSIONS This study shows that the Morse taper connection is a safe abutment connection. AF occurs more frequently within single crowns in molar area of males, especially with the positioning index (/X), while ASL is more likely to occur in an angled abutment.
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Affiliation(s)
- Fan Yang
- Center for Plastic & Reconstructive Surgery, Department of StomatologyZhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College)HangzhouZhejiangChina
| | - Yan Ruan
- Department of StomatologyBengbu Medical CollegeBengbuAnhuiChina
| | - Yunqing Liu
- Department of Restorative Dentistry, Division of Oral Health Science, Graduate School of Dental MedicineHokkaido UniversitySapporoJapan
| | - Jianping Chen
- Center for Plastic & Reconstructive Surgery, Department of StomatologyZhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College)HangzhouZhejiangChina
| | - Yunfang Chen
- Center for Plastic & Reconstructive Surgery, Department of StomatologyZhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College)HangzhouZhejiangChina
| | - Wentao Zhang
- Center for Plastic & Reconstructive Surgery, Department of StomatologyZhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College)HangzhouZhejiangChina
| | - Yude Ding
- Center for Plastic & Reconstructive Surgery, Department of StomatologyZhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College)HangzhouZhejiangChina
| | - Linhong Wang
- Center for Plastic & Reconstructive Surgery, Department of StomatologyZhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College)HangzhouZhejiangChina,Department of Restorative Dentistry, Division of Oral Health Science, Graduate School of Dental MedicineHokkaido UniversitySapporoJapan
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Kihara H, Hatakeyama W, Kondo H, Yamamori T, Baba K. Current complications and issues of implant superstructure. J Oral Sci 2022; 64:257-262. [PMID: 35989295 DOI: 10.2334/josnusd.21-0534] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
The purpose of this review is to search for complications of dental implant superstructures and consider the issues involved. This narrative review was performed by searching through PubMed databases and review articles that were published after 1990. Misfitting of the superstructure can result in loosening of screws, reduced preload, and in some cases, significant stress around the implant. External connection modalities and single implant prostheses have been reported to have more loose or broken abutment screws. In addition, when zirconia abutment was used for platform shifting, the rate of fracture of the abutment was considered to be high. Additionally, it was reported that men were significantly at an increased risk of abutment fracture. As for the retention mechanism of implant overdenture, stud attachment (Locator type) should receive more attention to wear and damage of retention parts than other attachments. The causes of the complications of implant superstructures have not been clarified in some cases, and further verification is required. Verification of complications is considered important to obtain a long-term prognosis for superstructures of implants. It will be necessary to further verify complications of implants in the future.
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Affiliation(s)
- Hidemichi Kihara
- Department of Prosthodontics and Oral Implantology, Iwate Medical University School of Dentistry
| | - Wataru Hatakeyama
- Department of Prosthodontics and Oral Implantology, Iwate Medical University School of Dentistry
| | - Hisatomo Kondo
- Department of Prosthodontics and Oral Implantology, Iwate Medical University School of Dentistry
| | - Tetsuo Yamamori
- Department of Prosthetic Dentistry, Ohu University School of Dentistry
| | - Kazuyoshi Baba
- Department of Prosthodontics, Showa University School of Dentistry
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Jin X, Guan Y, Ren J, Zhao Y, Wang X, He F. A retrospective study of 12,538 internal conical connection implants: focused on the long-term integrity of implant-abutment complexes. Clin Oral Implants Res 2022; 33:377-390. [PMID: 35113487 DOI: 10.1111/clr.13898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 12/29/2021] [Accepted: 01/24/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To evaluate the long-term integrity of implant-abutment complexes in implant systems with two internal conical angles. MATERIAL AND METHODS 12,538 bone-level implants of two systems placed between January 2012 and December 2018 were retrospectively analyzed. Cumulative abutment/implant fracture rates in systems with larger (LA, 7.5°) and smaller (SA, 5.7°) internal conical angles were estimated using Kaplan-Meier analysis and compared between groups. The association between implant systems and jammed abutment retrievability was evaluated by multivariable generalized estimating equation logistic regression modelling. RESULTS For LA, the 8-year cumulative incident rate was 0.10% (95% confidence interval (CI): 0-0.24%) for implant fracture and 0.26% (95% CI: 0.11%-0.41%) for abutment fracture, demonstrating a significant difference in gender (p = 0.03), implant diameter (p = 0.01), jaw (p = 0.006) and antagonist tooth (p < 0.001). For SA, the 8-year cumulative incident rate was 0.38% (95% CI: 0-0.79%) for implant fracture and 2.62% (95% CI: 0.05%-5.13%) for abutment fracture, which was influenced by implant diameter (p < 0.001) and site (p = 0.03). The cumulative implant/abutment fracture rate was lower for LA implants, particularly for LA implant-supported single crowns (SCs) (p < 0.05). The abutment-retrieval success rate was 92.8% for LA, and 57.1% for SA (p = 0.055). CONCLUSION LA implants exhibited a lower incidence of fracture in abutment-implant complexes and a relatively higher retrievability success rate for jammed abutments.
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Affiliation(s)
- Xiaoting Jin
- Department of Prosthodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, China
| | - Ye Guan
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, China
| | - Jie Ren
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, China
| | - Yanwei Zhao
- School of Materials Science and Engineering, Zhejiang University, Hangzhou, Zhejiang, China
| | - Xiaoxiang Wang
- School of Materials Science and Engineering, Zhejiang University, Hangzhou, Zhejiang, China
| | - Fuming He
- Department of Prosthodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, China
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Li QL, Yao MF, Cao RY, Zhao K, Wang XD. Survival Rates of Splinted and Nonsplinted Prostheses Supported by Short Dental Implants (≤8.5 mm): A Systematic Review and Meta-Analysis. J Prosthodont 2021; 31:9-21. [PMID: 34160869 DOI: 10.1111/jopr.13402] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2021] [Indexed: 12/15/2022] Open
Abstract
PURPOSE To evaluate and compare the implant survival rates, marginal bone loss, and mechanical complications of prostheses supported by splinted and nonsplinted short implants (≤8.5 mm). MATERIAL AND METHODS Electronic database (MEDLINE, CENTRAL, Web of Science, and EMBASE) and manual searches up to May 2021 were conducted to identify studies comparing splinted and nonsplinted short implants (≤8.5 mm). The primary outcome was implant survival rate. Secondary outcomes were marginal bone loss and mechanical complications. The quality of included studies and risk-of-bias were assessed according to the Newcastle-Ottawa Scale. A random-effects model was used to analyze the data. RESULTS Twelve studies fulfilled the inclusion criteria and featured 1506 short implants (596 nonsplinted and 910 splinted) with a follow-up time ranging from 1 to 16 years. Quantitative analysis found no statistically significant differences between splinted and nonsplinted short implants (≤8.5 mm) for survival rate (RR = 0.98; 95% CI 0.96, 1.01; p = 0.26)) and marginal bone loss (SMD = -0.08; 95% CI - 0.23, 0.07; p = 0.28). Veneer chipping, abutment screw breakage, screw loosening, and loss of retention were reported in the selected studies as common complications. However, no statistically significant difference was found between splinted and nonsplinted short implants (RR = 0.56; 95% CI 0.20, 1.54; p = 0.26). CONCLUSIONS Within the limitations of the present meta-analysis, it might be concluded that splinted short implants (≤8.5 mm) do not present superior performance in survival rate, marginal bone maintenance and prevention of mechanical complications compared with single-unit prostheses.
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Affiliation(s)
- Qiu-Lan Li
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, China
| | - Mian-Feng Yao
- Xiangya Hospital Central South University, Department of Stomatology, Changsha, Hunan, China
| | - Ruo-Yan Cao
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, China
| | - Ke Zhao
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, China
| | - Xiao-Dong Wang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, China
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