Impact of Mechanical Complications on Success of Dental Implant Treatments: A Case–Control Study

Patrícia W. Ferreira; Paulo J. Nogueira; Miguel A. de Araújo Nobre; Carlos Moura Guedes; Francisco Salvado

doi:10.1055/s-0041-1732802

European Journal of Dentistry, Inhaltsverzeichnis

CC BY 4.0 · Eur J Dent 2022; 16(01): 179-187
DOI: 10.1055/s-0041-1732802

Original Article

Impact of Mechanical Complications on Success of Dental Implant Treatments: A Case–Control Study

Patrícia W. Ferreira

¹Unidade de Epidemiologia, Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, Portugal

,

Paulo J. Nogueira

¹Unidade de Epidemiologia, Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, Portugal

,

Miguel A. de Araújo Nobre

¹Unidade de Epidemiologia, Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, Portugal

²Research, Development and Education Department, Maló Clinic, Avenida dos Combatentes, Lisboa, Portugal

³Clínica Universitária de Estomatologia, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, Portugal

,

Carlos Moura Guedes

⁴Prosthodontics Department, Maló Clinic, Avenida dos Combatentes, Lisboa, Portugal

,

Francisco Salvado

³Clínica Universitária de Estomatologia, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, Portugal

⁵Centro de Investigação Integrada Egas Moniz, Campus Universitário, Quinta da Granja, Caparica

› Institutsangaben

Abstract

Objective This study aimed to investigate the impact of mechanical complications on outcome measures for implant dentistry.

Materials and Methods This case–control study included 282 patients with mechanical complications occurring in fixed prosthetic rehabilitation supported by immediate function implants with external connection (cases) and 282 individuals without mechanical complications (control). Pairing was performed for sex, age (range = 3 years), and follow-up months (range = 11 months). The primary outcome measure was implant survival, while the secondary outcome measures were marginal bone loss and biological complication parameters (peri-implant pathology, soft tissue inflammation, fistula formation, and abscess formation).

Statistical Analysis Cumulative implant survival was estimated by using life tables. Descriptive statistics with 95% confidence intervals (CI) and inferential statistics (Chi-square test) were performed to evaluate differences between cases and controls. The significance level was set at 5%.

Results The average follow-up duration was 8.5 years. Mechanical complications included prosthetic fracture (n = 159), abutment loosening (n = 89), prosthetic screw loosening (n = 20), milled abutment (n = 12), milled prosthetic screw (n = 1), and decemented crown (n = 1). Implant failure occurred in one patient from the control group, with survival rates of 100 and 99.6% for cases and controls, respectively (p = 0.317). The average marginal bone loss was 1.72 (95% confidence interval [CI]: 1.60–1.84) for cases and 1.55 (95% CI: 1.45–1.65) for controls (p = 0.068). Biological complications were observed in 90 patients, with significant differences between cases (n = 54) and controls (n = 36; p = 0.038).

Conclusion Mechanical complications did not significantly influence survival or marginal bone loss; nevertheless, there is a need for studies with longer follow-up duration. Mechanical complications also significantly influence the incidence of biological complications.

Keywords

dental implants - complications - implant survival - bone loss

Volltext

Referenzen

References
1 Emami E, de Souza RF, Kabawat M, Feine JS. The impact of edentulism on oral and general health. Int J Dent 2013; 2013: 498305
2 Swedish Council on Health Technology Assessment. Prosthetic rehabilitation of partially dentate or edentulous patients: A systematic review [Internet]. Stockholm: Swedish Council on Health Technology Assessment (SBU); 2010. 3–25. Available at:http://www.ncbi.nlm.nih.gov/books/NBK448012. Accessed 2010
3 Maló P, Rangert B, Dvärsäter L. Immediate function of Brånemark implants in the esthetic zone: a retrospective clinical study with 6 months to 4 years of follow-up. Clin Implant Dent Relat Res 2000; 2 (03) 138-146
4 Gapski R, Wang HL, Mascarenhas P, Lang NP. Critical review of immediate implant loading. Clin Oral Implants Res 2003; 14 (05) 515-527
5 Malo P, de Araújo Nobre M, Lopes A, Moss SM, Molina GJ. A longitudinal study of the survival of All-on-4 implants in the mandible with up to 10 years of follow-up. J Am Dent Assoc 2011; 142 (03) 310-320
6 Al-Sawai AA, Labib H. Success of immediate loading implants compared to conventionally-loaded implants: a literature review. J Investig Clin Dent 2016; 7 (03) 217-224
7 Del Fabbro M, Testori T, Kekovic V, Goker F, Tumedei M, Wang HL. A systematic review of survival rates of osseointegrated implants in fully and partially edentulous patients following immediate loading. J Clin Med 2019; 8 (12) 2142
8 Salvi GE, Brägger U. Mechanical and technical risks in implant therapy. Int J Oral Maxillofac Implants 2009; 24 (Suppl 69-85
9 Schwarz MS. Mechanical complications of dental implants. Clin Oral Implants Res 2000; 11 (Suppl. 01) 156-158
10 Fu JH, Hsu YT, Wang HL. Identifying occlusal overload and how to deal with it to avoid marginal bone loss around implants. Eur J Oral Implantology 2012; 5 (Suppl S91-S103
11 Pjetursson BE, Thoma D, Jung R, Zwahlen M, Zembic A. A systematic review of the survival and complication rates of implant-supported fixed dental prostheses (FDPs) after a mean observation period of at least 5 years. Clin Oral Implants Res 2012; 23 (Suppl. 06) 22-38
12 Prithviraj DR, Srivastava R, Gaur S, Patil A, Raj KS, DP Shruthi. Prosthodontic complications associated with dental implants: a review of literature. Int J Ther Appl 2016; 31: 47-53
13 Shemtov-Yona K, Rittel D. An overview of the mechanical integrity of dental implants. BioMed Res Int 2015; 2015: 547384
14 Pommer B, Bucur L, Zauza K, Tepper G, Hof M, Watzek G. Meta-analysis of oral implant fracture incidence and related determinants. J Oral Implants 2014; ID263925
15 Dupont WD, Plummer Jr WD. Power and sample size calculations. A review and computer program. Control Clin Trials 1990; 11 (02) 116-128
16 Maló P, de Araújo Nobre M. Partial rehabilitation of the posterior edentulous maxilla using axial and tilted implants in immediate function to avoid bone grafting. Compend Contin Educ Dent 2011; 32 (09) E136-E145
17 Maló P, Rangert B, Nobre M. Mise en fonction immediate d’implants Brånemark® pour la restauration d’édentements unitaires et de faible étendue maxillaires et mandibulaires. Étude clinique rétrospective de 6 mois à 8 ans. Implant 2005; 11: 23-32
18 Maló P, Nobre Md, Lopes A. The rehabilitation of completely edentulous maxillae with different degrees of resorption with four or more immediately loaded implants: a 5-year retrospective study and a new classification. Eur J Oral Implantology 2011; 4 (03) 227-243
19 Maló P, Nobre Md. Flap vs. flapless surgical techniques at immediate implant function in predominantly soft bone for rehabilitation of partial edentulism: a prospective cohort study with follow-up of 1 year. Eur J Oral Implantology 2008; 1 (04) 293-304
20 Maló P, Rangert B, Nobre M. All-on-4 immediate-function concept with Brånemark System implants for completely edentulous maxillae: a 1-year retrospective clinical study. Clin Implant Dent Relat Res 2005; 7 (Suppl. 01) S88-S94
21 Ericsson I, Randow K, Nilner K, Peterson A. Early functional loading of Brånemark dental implants: 5-year clinical follow-up study. Clin Implant Dent Relat Res 2000; 2 (02) 70-77
22 Manfredini D, Poggio CE, Lobbezoo F. Is bruxism a risk factor for dental implants? A systematic review of the literature. Clin Implant Dent Relat Res 2014; 16 (03) 460-469
23 Bertolini MM, Del Bel Cury AA, Pizzoloto L, Acapa IRH, Shibli JA, Bordin D. Does traumatic occlusal forces lead to peri-implant bone loss? A systematic review. Braz Oral Res 2019; 33 (Suppl. 01) e069
24 Dawood A, Marti BM, Tanner S. Peri-implantitis and the prosthodontist. Br Dent J 2017; 223 (05) 325-332
25 de Araújo Nobre M, Mano Azul A, Rocha E, Maló P. Risk factors of peri-implant pathology. Eur J Oral Sci 2015; 123 (03) 131-139
26 Rokaya D, Srimaneepong V, Wisitrasameewon W, Humagain M, Thunyakitpisal P. Peri-implantitis update: risk indicators, diagnosis, and treatment. Eur J Dent 2020; 14 (04) 672-682
27 Schou S. Implant treatment in periodontitis-susceptible patients: a systematic review. J Oral Rehabil 2008; 35 (Suppl. 01) 9-22
28 Lin CY, Chen Z, Pan WL, Wang HL. Is history of periodontal disease still a negative risk indicator for peri-implant health under supportive post-implant treatment coverage? A systematic review and meta-analysis. Int J Oral Maxillofac Implants 2020; 35 (01) 52-62
29 Clementini M, Rossetti PH, Penarrocha D, Micarelli C, Bonachela WC, Canullo L. Systemic risk factors for peri-implant bone loss: a systematic review and meta-analysis. Int J Oral Maxillofac Surg 2014; 43 (03) 323-334
30 Hadi SA, Ashfaq N, Bey A, Khan S. Biological factors responsible for failure of osseointegration in oral implants. Biol Med (Aligarh) 2011; 3: 164-170
31 Chrcanovic BR, Albrektsson T, Wennerberg A. Smoking and dental implants: a systematic review and meta-analysis. J Dent 2015; 43 (05) 487-498
32 Kumar PS. Systemic risk factors for the development of peri-implant diseases. Implant Dent 2019; 28 (02) 115-119
33 de Araújo Nobre M, Mano Azul A, Rocha E, Maló P, Salvado F. Attributable fractions, modifiable risk factors and risk stratification using a risk score for peri-implant pathology. J Prosthodont Res 2017; 61 (01) 43-53
34 de Araújo Nobre M, Salvado F, Nogueira P, Rocha E, Ilg P, Maló P. A peri-implant disease risk score for patients with dental implants: validation and the influence of the interval between maintenance appointments. J Clin Med 2019; 8 (02) 252
35 Lopes A, Maló P, de Araújo Nobre M, Sánchez-Fernández E, Gravito I. The Nobel-Guide(®) All-on-4(®) treatment concept for rehabilitation of edentulous jaws: a retrospective report on the 7-years clinical and 5-years radiographic outcomes. Clin Implant Dent Relat Res 2017; 19 (02) 233-244