and 1 other(s)
Background There have been several studies on fracture of the implant components, most studies report only failure of the osseointegration and it is overlooked that implant failure can be caused by implant component fracture. Clinically, in the case of implant abutment fracture or screw fracture, it is recommended to remake the prosthesis after removing the fractured remnant, however, it is difficult to remove the fragments and eventually the implants must be removed, leading to failure. Aim/Hypothesis The aim of this study was to predict the prognosis of implants and to suggest directions for successful implant treatment by analyzing the factors affecting the fracture of implant components including abutment connection type, implant location and implant platform size. Materials and Methods Data were collected from the clinical records of all patients who received one or more WARANTEC implants at Seoul National University Dental Hospital from February 2002 to January 2014 for 12 years. Data collection included 406 patients (205 males, 201 females), ranging in age from 21 to 94 years (mean 64.6 years, SD 11.5). Total number of implants were 1,289 and an average of 3.2 implants were installed per patient. Information about abutment connection type (internal or external), implant locations, platform sizes was collected with presence of implant component fractures and their managements. The information about implant component fractures was divided into three types: screw fractures, abutment fractures, and fixture fractures. The management of fractures was classified as screw replacement, prosthesis refabrication, and fixture removal. SPSS statistics software (version 24.0, IBM) was used for the statistical analysis. Resultats Overall fracture was significantly more frequent in internal type. The most frequently fractured component was abutment in internal type implants, and screw fracture occurred most frequently in external type. The most frequent location which implant component fractures occurred was the maxillary posterior region in internal type, and maxillary anterior region in external type. Analyzing by fractured components, screw fracture was the most frequent in the maxillary anterior region and the most abutment fracture occurred in the maxillary posterior region significantly. There was significant relationship between platform size and fractures. In external type, the number of fractures of NP was larger than that in other platform sizes, and more fractures occurred in the RP than other platform sizes in internal type. Analyzing by fractured components, screw fractures occurred more frequently in NP (narrow platform) and abutment fractures occurred more frequently in RP (regular platform). Conclusion and clinical implications In external type, screw fracture occurred most frequently, especially in the maxillary anterior region, and in internal type, abutment fracture occurred frequently in the posterior region. The screw fracture seems to be easier to solve than the abutment fracture. Therefore, placement of an external type implant rather than an internal type is recommended for the posterior region where abutment fractures frequently occur.
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