An Overview of the Mechanical Integrity of Dental Implants

Abstract

With the growing use of dental implants, the incidence of implants' failures grows. Late treatment complications, after reaching full osseointegration and functionality, include mechanical failures, such as fracture of the implant and its components. Those complications are deemed severe in dentistry, albeit being usually considered as rare, and therefore seldom addressed in the clinical literature. The introduction of dental implants into clinical practice fostered a wealth of research on their biological aspects. By contrast, mechanical strength and reliability issues were seldom investigated in the open literature, so that most of the information to date remains essentially with the manufacturers. Over the years, implants have gone through major changes regarding the material, the design, and the surface characteristics aimed at improving osseointegration. Did those changes improve the implants' mechanical performance? This review article surveys the state-of-the-art literature about implants' mechanical reliability, identifying the known causes for fracture, while outlining the current knowledge-gaps. Recent results on various aspects of the mechanical integrity and failure of implants are presented and discussed next. The paper ends by a general discussion and suggestions for future research, outlining the importance of mechanical considerations for the improvement of their future performance.

Principles of biomechanics in oral implantology

“…Even the best results in laboratory testing and FEA cannot guarantee clinical success, if the basic biomechanical principles are not taken into consideration during insertion and loading. The leading cause of dental implant loss is considered to be of biological nature but mechanical complications (implant fracture, abutment screw fracture, and abutment fracture) are almost as important [9,10]. Failure can also come from an incorrect prosthetic plan (no metal framework in OD, Cantilever > 15 mm, extreme length of the reconstruction, splinting teeth and implants, ignoring the patient's anatomy and function ( Figure 2) etc.)…”

“…The most frequently taken into account local parameters concerning the implant are related to diameter, length and angulation, dictated by the bone anatomy. Also, the implant design is taken into consideration, especially when evaluating the bone quality (density) [9,12]. Practitioners are also increasingly aware of the implant surface treatment, with a considerable effect on osseointegration and function [13].…”

Non-Washed Resorbable Blasting Media (NWRBM) on Titanium Surfaces could Enhance Osteogenic Properties of MSCs through Increase of miRNA-196a And VCAM1

“…[3,4] At a biological level, osseointegration is defined as close contact between the implant surface and the surrounding bone. [5,6] This is strictly dependent on the surface geometry and topography of the device.…”

Evaluation of Topical Application of Nigella Sativa (Black Seeds) on Delayed Dental Implant

“…The main issue in implant osseointegration is surface irregularity, that demonstrated to raise osteoblast action in contrast to a smooth surface (7) . Surface roughness of the implant has been improved via different means as machining, plasma spray coating, grit blasting, acid etching, sandblasted and acid etching (SLA), anodizing, and biomimetic coating (8,9) .…”