Risk factors for abutment and implant fracture after loading

Murakami, Hiroshi; Igarashi, Kentaro; Fusé, Megumi; Kitagawa, T.; Igarashi, Mitsuhiko; Uchibori, Satoshi; Komine, Chiaki; Gotouda, Hiroya; Okada, Hiroyuki; Kawai, Yasuhiko

doi:10.2334/josnusd.20-0443

Cited by 12 publications

(17 citation statements)

References 28 publications

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“…At the end of the study, there were 14 abutment fractures (0.14%) and four implant fractures (0.04%) in 10,231 LA implants. During the same period, there were 14 abutment fractures (0.61%) and five implant fractures (0.22%) in 2307 SA implants, corresponding to a lower fracture percentage than those observed in previous studies involving Asian cohorts (Murakami et al, 2020; Shim & Yang, 2015). Shim et al reported ten abutment fractures in 450 SA implants (2.2%), and Murakami et al revealed 18 abutment fractures (1.6%) and eight implant fractures (0.7%) in 1126 SA implants over a 10‐year follow‐up period.…”

Section: Discussionmentioning

confidence: 53%

“…Asian cohorts (Murakami et al, 2020;Shim & Yang, 2015). Shim et al reported ten abutment fractures in 450 SA implants (2.2%), and Murakami et al revealed 18 abutment fractures (1.6%) and eight implant fractures (0.7%) in 1126 SA implants over a 10-year followup period.…”

Section: Discussionmentioning

confidence: 99%

“…In one study, biological complications, such as peri‐implantitis, accounted for all the implant failures, while neither abutment fractures nor implant fractures were reported in an internal conical implant system incorporating a 7.5° taper (Filippi et al, 2013; French et al, 2015). Another implant system, however, with an internal conical taper of 5.7° reportedly had an implant component fracture rate of 0.2%–2.2% (Murakami et al, 2020; Shim & Yang, 2015).…”

Section: Introductionmentioning

confidence: 99%

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A retrospective study of 12,538 internal conical connection implants focused on the long‐term integrity of implant–abutment complexes

Jin

Guan

Ren

et al. 2022

Clinical Oral Implants Res

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Objective 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 the 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 modeling. 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 = .03), implant diameter (p = .01), jaw (p = .006), and antagonist tooth (p < .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 < .001) and site (p = .03). The cumulative implant/abutment fracture rate was lower for LA implants, particularly for LA implant‐supported single crowns (SCs) (p < .05). The abutment‐retrieval success rate was 92.9% for LA and 57.1% for SA (p = .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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Section: Discussionmentioning

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A retrospective study of 12,538 internal conical connection implants focused on the long‐term integrity of implant–abutment complexes

Jin

Guan

Ren

et al. 2022

Clinical Oral Implants Res

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“…After removing duplicates and articles that did not fulfill the inclusion criteria, 46 potentially pertinent records remained (κ = 0.88). After the full texts were evaluated, 34 studies were further excluded, for the following reasons: Two 26,27 studies included implantsupported complete-arch prosthesis patients; 12 studies did not report implant length; 6,[28][29][30][31][32][33][34][35][36][37][38] 11 studies combined data for short and long implants, [39][40][41][42][43][44][45][46][47][48][49] and 9 studies did not involve short implants. [50][51][52][53][54][55][56][57][58] Ultimately, 12 studies satisfied the inclusion cri-teria and were included in the meta-analysis.…”

Section: Resultsmentioning

confidence: 99%

Survival Rates of Splinted and Nonsplinted Prostheses Supported by Short Dental Implants (≤8.5 mm): A Systematic Review and Meta‐Analysis

Yao

Cao

et al. 2021

Journal of Prosthodontics

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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.Although the exact definition remains controversial, 1-3 short dental implants have been proven to be an acceptable solution for patients with limited alveolar bone height, which could substantially reduce treatment procedures, time, cost, and postoperative complications. 4,5 The survival rate of short implants is considered to be affected by a variety of factors. Implant factors include the lengths and surface treatments of implants and implant-abutment connection design. 6 Surgical and prosthetic factors include implant position (maxilla or mandible), surgical trauma, loading, etc. 6,7 Moreover, it is worth noting that selection of a suitable rehabilitation modality for short implants is also considered a crucial factor to maintain the long-term stability and success of short implants. 8

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“…28 As a result, the crown will not fall off even if the abutment screw is loosened, and thus the abutment often remains stably fixed even with a loosened screw. 6 This may be one of the reasons why ASL is rare after the use of this system. In addition, there was no significant difference in ASL between the indexed and non-indexed abutments.…”

Section: Discussionmentioning

confidence: 99%

Abutment mechanical complications of a Morse taper connection implant system: A 1‐ to 9‐year retrospective study

Yang

Ruan

Liu

et al. 2022

Clin Implant Dent Rel Res

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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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Risk factors for abutment and implant fracture after loading

Cited by 12 publications

References 28 publications

A retrospective study of 12,538 internal conical connection implants focused on the long‐term integrity of implant–abutment complexes

A retrospective study of 12,538 internal conical connection implants focused on the long‐term integrity of implant–abutment complexes

Survival Rates of Splinted and Nonsplinted Prostheses Supported by Short Dental Implants (≤8.5 mm): A Systematic Review and Meta‐Analysis

Abutment mechanical complications of a Morse taper connection implant system: A 1‐ to 9‐year retrospective study

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