Incidence and Management of Fractured Dental Implants

Jin, Soo-Young; Kim, Su-Gwan; Oh, Ji‐Su; You, Jun; Jeong, Mi‐Ae

doi:10.1097/id.0000000000000653

Cited by 8 publications

(5 citation statements)

References 12 publications

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“…The exclusive use of trephine drills is reported in cases of fixture and/or abutment fracture. Two studies combine the use of trephine burs with GBR for new implant placement [ 28 , 29 ]; an article instead adds a sinus floor elevation to this method [ 30 ]. One study used high-speed burs [ 31 ]: diamond and carbide burs (round and fissure) with irrigation combined with the use of forceps and elevators.…”

Section: Resultsmentioning

confidence: 99%

A systematic review on removal of osseointegrated implants: un update

Tafuri,

Santilli,

Manciocchi

et al. 2023

BMC Oral Health

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Background Today dental implants represent an effective therapy in case of partial or total edentulism, with an excellent success rate. Despite the results obtained, there may be biological or mechanical complications during the therapy, which lead to the loss of the implant. This systematic review aims to evaluate the current state of the art in the literature on techniques used for the removal of dental implants. Various aspects will be analyzed, such as the success of the technique, any complications, and the advantages and disadvantages of their use. Methods Two reviewers conducted a literature analysis (PubMed, Embase, Web of Science) of the last 20 years (2003–2023). The main criterion analyzed was the success of the technique, while secondary outcomes such as complications and risks of the technique were also analyzed. 258 articles were identified in the various search databases. 42 eligible articles were subsequently identified after an article screening. Only 18 full texts were subsequently included in the review. Results A total of 18 articles were selected and 1142 implants and 595 patients were included. The main techniques used were the Counter-Torque Ratchet Technique (CTRT), Piezoelectric bone surgery (PBS), trephine drills, carbide burs, Erbium, Chromium, Yttrium, Scandium, Gallium, Garnett (Er:Cr:YSGG) laser and carbon dioxide (CO2) laser. Combined uses of techniques have been identified such as: PBS and trephine burs or carbide burs, trephine burs with the use of a 3d-printed guide, CTRT and trephine burs. The technique with the highest success rate, less morbidity for the patient, and less removal of bone appears to be the CTRT. Conclusions The use of conservative techniques, especially CTRT, in bone removal is useful to allow for immediate implant placement in the removal area. However, further studies with a high sample size are needed to be performed on all techniques, particularly new randomized controlled trials (RCTs) that allow for the analysis of the success of alternative techniques such as Laser and Piezosurgery, which appear to be very promising.

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Section: Resultsmentioning

confidence: 99%

A systematic review on removal of osseointegrated implants: un update

Tafuri,

Santilli,

Manciocchi

et al. 2023

BMC Oral Health

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“…This means that implant fracture can occur prior to bone loss in some cases and hence it is necessary to diagnose the fracture in a timely manner in order to minimize the amount of bone defect that occurs around the fractured implant and therefore the need for future augmentation procedures. Several studies have been performed on the prevalence and related risk factors of implant fracture 1 , 11 , 29 , 30 ; nevertheless, no attempts so far have been made to identify the best radiographic modality for accurate diagnosis of fractures in dental implants. Since the radiodensity and geometric configuration of dental implants are very different from natural teeth, a survey on different radiographic methods is necessary to define the best technique.…”

Section: Discussionmentioning

confidence: 99%

“…Fracture of the body of the implant is a relatively rare complication with an estimated incidence of 0.2–2.3% 1 – 5 . Despite its rarity, implant fracture is one of the most serious complications since it often necessitates removal of the fractured fixture which results in severe bone defects around the removal site 6 – 11 . In most cases, fractures secondary to bone loss and bone loss secondary to fractures are hard to distinguish; therefore, the diagnosis of implant fracture might be delayed if the clinician solely relies on the bone loss as a fracture sign.…”

Section: Introductionmentioning

confidence: 99%

A diagnostic accuracy study on an innovative auto-edge detection technique for identifying simulated implant fractures on radiographic images

Khosravifard

Saberi

Khosravifard

et al. 2022

Sci Rep

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Implant fracture is a rare but devastating complication of treatment in partially or fully edentulous patients which requires prompt diagnosis. Nevertheless, studies on defining the most accurate technique for the detection of implant fractures are lacking. In the present study, the Canny edge detection algorithm was applied on multiple radiographic modalities including parallel periapical (PPA), oblique periapical (OPA), and cone beam CT (CBCT) with and without metal artifact reduction (MAR) to examine its accuracy for diagnosis of simulated implant fractures. Radiographs were taken from 24 intact implants and 24 implants with artificially created fractures. Images were evaluated in their original and Canny formats. The accuracy of each radiograph was assessed by comparison with a reference standard of direct observation of the implant. The greatest area under the receiver operating characteristic curve belonged to Canny CBCT with MAR (0.958), followed by original CBCT with MAR (0.917), original CBCT without MAR = Canny CBCT without MAR = Canny OPA (0.875), Canny PPA (0.833), original PPA = original OPA (0.792), respectively. The Canny edge detection algorithm is suggested as an innovative method for accurate diagnosis of clinically suspected implant fractures on CBCT and periapical radiographies.

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“…The diagnosis of implant fractures requires the detection of implant mobility by clinical examination and of the fracture line by X-ray images[ 1 ]. Once diagnosed as an implant fracture, conventional treatment options are: (1) Complete removal of the remaining fractured implant using trephines[ 6 ]; (2) Removal and replacement of the coronal portion of the fractured implant with a new prosthetic restoration[ 7 ]; (3) Leaving the remaining apical part integrated into the bone and placing a fixed bridge instead[ 8 , 9 ]; and (4) Using a computer-aided design/computer-aided manufacturing surgical guide to remove the buried implant[ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Osteotomy combined with the trephine technique for invisible implant fracture: A case report

Chen¹,

Wang²,

Xia³

et al. 2022

WJCC

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BACKGROUND Implant fracture is one of the most serious mechanical complications of dental implants. Conventional treatment necessitates visibility of the apical portion of the fractured implant, whereas for deep and invisible implant fractures, the traditional trephine method has been ineffective. Surgical removal of the marginal bone to expose the fracture surface would be a time-consuming and extensively damaging procedure. Here, we propose a novel technique to address invisible implant fractures. CASE SUMMARY A 50-year-old woman was referred to our department with the chief complaint that her right mandibular implant tooth had fallen out 3 mo earlier. Cone-beam computed tomography examination showed an implant fracture with a fracture surface 5.1 mm below the crestal ridge. The patient was treated with osteotomy combined with the trephine technique to expose the surgical field and remove the implant. The invisible fractured implant was successfully removed, with minimal trauma. A modified Wafer technique-supported guided bone regeneration treatment was then administered to restore the buccal bone wall and preserve the bone mass. Six months later, fine regenerative bone and a wide alveolar crest in the edentulous area were observed, and a new implant was placed. Four months later, restoration was completed using a cemented ceramic prosthesis. Clinical and radiographic examinations 12 mo after loading fulfilled the success criteria. The patient reported no complaints and was satisfied. CONCLUSION Osteotomy combined with the trephine technique can be effectively used to address deep and invisible implant fractures.

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Incidence and Management of Fractured Dental Implants

Cited by 8 publications

References 12 publications

A systematic review on removal of osseointegrated implants: un update

A systematic review on removal of osseointegrated implants: un update

A diagnostic accuracy study on an innovative auto-edge detection technique for identifying simulated implant fractures on radiographic images

Osteotomy combined with the trephine technique for invisible implant fracture: A case report

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