Objectives This study investigated fracture rates and risk indicators for fractures in internal connection dental implants. Material and Methods We performed a retrospective analysis of 19,006 internal connection implants used in fixed restoration in 5,124 patients (4,570 males, 554 females) at the Dental Hospital of Veterans Health Service Medical Center between 2006 and 2015. Patients were followed through June 2018 (0.03–12.39 years post‐installation). Clinical factors (age, sex, implant diameter, implant length, placement site, bone graft, fixture material, cervical feature, abutment connection, microthread, and platform switching) were recorded. Kaplan–Meier survival analysis identified risk indicators associated with an implant fracture. Cox regression models elucidated potential fracture risks. Results One hundred and seventy‐four implants fractured in 135 patients, for an incidence rate of 0.92% after an average of 4.95 ± 2.14 years of use. Kaplan–Meier estimates showed that the 3‐, 5‐, and 10‐year survival rates of implants were 99.8%, 99.2%, and 97.7%, respectively. In the multivariable Cox regression model, the diameter, location, history of bone graft, and microthread presence were significantly correlated with implant fractures. Wide‐diameter implants had a reduced fracture risk within 90 months, after which the diameter did not correlate with fractures. Implants placed in the anterior mandible had a lower fracture risk within 90 months; mandibular premolar implants corresponded with a lower risk after 90 months. Implants without a history of bone graft or microthreads were more likely to fracture throughout the follow‐up time. Conclusions These results elucidate risk indicators for implant fractures and facilitate their reduction in clinical practice.

PURPOSEThe purpose of this study was to compare the width ratio of maxillary anterior teeth according to age in the Korean population and to evaluate the maxillary central incisor width-to-length (W/L) ratio, given differences in age and gender.MATERIALS AND METHODSNinety-three Korean adults were divided into 3 groups (n = 31) by age. Group I was 20 - 39 years old, Group II was 40 - 59 years old, and Group III was over 60 years of age. After taking an impression and a cast model of the maxillary arch, the anterior teeth width ratio and central incisor W/L ratio were calculated from standard digital images of the cast models using a graph paper with a digital single lens reflex (DSLR) camera. The calculated ratios were compared among all groups and central incisor W/L ratio were analyzed according to age and gender. All comparative data were statistically analyzed with one-sample t-tests, one-way ANOVAs with Tukey tests, and independent t-tests.RESULTSNo significant differences in maxillary anterior teeth ratios were found among the age groups. The maxillary central incisor W/L ratios in Group III were the greatest and were significantly higher than those in the other groups. The central incisor W/L ratio of men was higher than that of women in Group II.CONCLUSIONMaxillary anterior teeth width ratios were similar in all age groups in the Korean population. The maxillary central incisor was observed as worn teeth in the group over 60 years of age, and a significant difference between genders was found in 40 to 50 year olds.