Fracture of the anterior segment of the atrophic mandible related to dental implants

Almasri, Mazen; El-Hakim, Michel

doi:10.1016/j.ijom.2012.01.004

Cited by 31 publications

(23 citation statements)

References 7 publications

(9 reference statements)

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“…That requires selection of patient, careful surgical technique, and postoperative care. Although such complications are rare, it is needed to be discussed preoperatively since the treatment of mandible fractures related to implants is complicated [3]. …”

Section: Discussionmentioning

confidence: 99%

“…Such surgical procedures are anticipated, however, complications can be seen such as infection, improper placement, neurosensory injury, bleeding and mandible fracture which has a reported occurrence rate of 0.2%. The rate of incidence seems to be low, but it leads to overwhelming outcomes such as malunion, non-union, paresthesia, osteomyelitis and prolonged functional and nutritional disturbances [3]. On the other hand, the mandible is the most common broken bone by cause of facial injuries with the ratio of 23–97% [4].…”

Section: Introductionmentioning

confidence: 99%

“…The insertion of implants to the weakend mandibular bone decreases the strength of the bone and may lead to fractures either during or after implant placement [5]. Numerous case reports of fractured athrophic mandible secondary to implant insertion were reported in the literature [3, 6–8]. …”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Evaluating the biomechanical effects of implant diameter in case of facial trauma to an edentulous atrophic mandible: a 3D finite element analysis

Ayalı

Bilginaylar

2017

Head Face Med

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BackgroundRehabilitation using an implant supported overdenture with two implants inserted in the interforaminal region is the easiest and currently accepted treatment modality to increase prosthetic stabilization and patient satisfaction in edentulous patients. The insertion of implants to the weakend mandibular bone decreases the strength of the bone and may lead to fractures either during or after implant placement. The aim of this three dimensional finite element analysis (3D FEA) study was to evaluate the biomechanical effects of implant diameter in case of facial trauma (2000 N) to an edentulous atrophic mandible with two implant supported overdenture.MethodsThree 3D FEA models were simulated; Model 1 (M1) is edentulous atrophic mandible, Model 2 (M2), 3.5x11.5 mm implants were inserted into lateral incisors area of same edentulous atrophic mandible, Model 3 (M3), 4.3x11.5 mm implants were inserted into lateral incisors area of same edentulous atrophic mandible.ResultsIn M1 and M2 highest stress levels were observed in condylar neck, whereas highest stress values in M3 were calculated in symphyseal area.ConclusionsTo reduce the risk of bone fracture and to preserve biomechanical behavior of the atrophic mandible from frontal traumatic loads, implants should be inserted monocortically into spongious bone of lateral incisors area.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Evaluating the biomechanical effects of implant diameter in case of facial trauma to an edentulous atrophic mandible: a 3D finite element analysis

Ayalı

Bilginaylar

2017

Head Face Med

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“…In 2012, Almasri and El-Hakim in a PubMed search revealed 13 cases of fractured atrophic mandible secondary to implant placement. 26 The technique of distraction osteogenesis has advantages compared with grafting procedures, as it does not require a donor area. This difference results in lower morbidity and the presence of vital bone in the distraction area (and therefore in the region that will receive the implant) in addition to an increase in soft tissue.…”

Section: Discussionmentioning

confidence: 99%

Current Therapeutic Options for Implant-Supported Rehabilitation of Severely Atrophic Mandibles

Júnior

Araújo

Mendes

et al. 2018

Craniomaxillofacial Trauma & Reconstruction Open

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The implant-supported rehabilitation of atrophic mandibles (AM) with severe bone resorption is challenging for both surgical and prosthetic procedures due to the high risk of mandible fracture during implant surgery and postoperatively due to the masticatory load. The aim of case presentations was to demonstrate treatment alternatives for patients with AM who required oral rehabilitation with osseointegrated implants (OIs) according to the residual mandibular bone volume. When bone is 9 mm in height, the ideal treatment is the use of narrow, short OIs. When the bone height is 5 to < 9 mm, mandibular reinforcement with reconstruction plates using the intraoral approach and simultaneous placement of osseointegrated implants are proposed. In cases where bone height is < 5 mm, the choice of treatment is mandibular reconstructive surgery with an autogenous bone graft and biomaterials. The fundamental principles of this protocol are to reduce the morbidity and complications associated with the surgical procedure, which would reduce both the time and cost of full dental rehabilitation. The choice of the technique for mandibular reconstruction should be indicated according to the magnitude of the atrophy.

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“…Therefore, the use of dental implants without bone grafting in cases with marginal bone defi ciencies of the mandible could be a viable treatment option. However, it has been reported that the possibility of dental implantrelated bone fracture should be considered in patients with atrophied mandibles 5,6) Moreover, an unbalanced occlusal force could increase the risk of fracture in the resected region of the mandible 7,8) . These reports indicate occlusal force by dental implants is traumatic force to possibly induce pathological fracture at the resected region in the mandible.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Influence Factors to Reduce Mechanical Stress on the Marginally Resected Mandibular Bone Against Dental Implant-supported Occlusion

Tamai

Hirota

Iwai

et al. 2018

J. Hard Tissue Biology.

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This study aimed to evaluate the mechanical stress on resected mandibular bone against occlusal force using dental implant without any bone grafting by fi nite element analysis to reduce the risk of the bone fracture. A model of marginal resection of the symphysis of the mandible, in which the bone height of the region was 5, 10 or 15 mm, was prepared. Two, four, or six implant-supported fi xed prostheses (superstructure) or overdenture were set up in the model and loaded with 500N of occlusal force. The von Mises stress on the resected region was the highest when two implants were bilaterally placed at positions closest to the resected region. The von Mises stress value on the resected region could be high enough to induce the bone fracture. The mechanical stress was reduced up to < 50 % by adding implant at posterior position and connecting all implants. The presence of superstructure on 4 or 6 implants signifi cantly decreased the von Mises stress when the residual bone height was 10 or 15 mm. Use of 6 implants showed no signifi cant advantage at the stress reduction compared to use of 4 implants. When the residual bone height was 5 mm, reinforcement of the residual bone or bone graft should be considered to avoid the bone fracture. Although the present results were obtained under restrictive conditions, the number of implant, implant position, and prostheses style could reduce the von Mises stress and the risk of bone fracture on the resected region.

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Fracture of the anterior segment of the atrophic mandible related to dental implants

Cited by 31 publications

References 7 publications

Evaluating the biomechanical effects of implant diameter in case of facial trauma to an edentulous atrophic mandible: a 3D finite element analysis

Evaluating the biomechanical effects of implant diameter in case of facial trauma to an edentulous atrophic mandible: a 3D finite element analysis

Current Therapeutic Options for Implant-Supported Rehabilitation of Severely Atrophic Mandibles

Evaluation of Influence Factors to Reduce Mechanical Stress on the Marginally Resected Mandibular Bone Against Dental Implant-supported Occlusion

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