Implant fracture failure rate and potential associated risk indicators: An up to 12‐year retrospective study of implants in 5,124 patients

Abstract

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.

The effect of smoking on the marginal bone loss around implant-supported prostheses

“…Since panoramic radiography has been reported to be a simple and reliable method of measuring bone level changes, we assessed the implant failure threats at the points where the bones were attached to the implants using recall session panoramic radiographs 17 . In accordance with the results of previous investigations, we confirmed that age and sex were not associated with MBL 18,19 .…”

Risk factors for abutment and implant fracture after loading

“…Second, a relationship between the absence of hard tissue management and fracture of the abutment or implant was also found on univariate analysis (P = 0.040). Implants at the bone grafting sites reportedly have a low risk of fracture [38]. Because several factors are interrelated, it is considered that no association was found on multivariate analysis after adjusting for confounders.…”

Fractures of implant fixtures: a retrospective clinical study

“…Most of the fractured implants in this study were implants with a length greater than 11.5 mm. However, a study by Tabrizi et al [18] and Lee et al [21] reported no significant correlation between implant length and fixture fracture. Therefore, further research is necessary in this area.…”

“…In this study, the number of cases was insufficient, but the diameter of the fractured implants varied in 2 cases by 3.8 mm, 3 cases by 4 mm, 5 cases by 4.5 mm, and 2 cases by 5 mm. However, it should be noted that many papers report that the smaller the diameter of the implant, the greater the possibility that fracture occurs [7,[19][20][21].…”