The Journal of Korean Academy of Prosthodontics (대한치과보철학회지)

The Korean Academy of Prosthodonitics (대한치과보철학회)
권호 표지
DOI QR코드

DOI QR Code

The incidence of the abutment screw loosening and its affecting factors in posterior implant restorations

구치부 임플란트 고정성 수복물에서의 지대주 나사 풀림 현상과 이에 영향을 미치는 요인

  • Hong, Su-Jung (Department of Prosthodontics, Gil Medical Center, Gachon University) ;
  • Bae, Jung-Yoon (Department of Prosthodontics, Gil Medical Center, Gachon University) ;
  • Kim, Hyun-Hee (Department of Prosthodontics, Gil Medical Center, Gachon University)
  • 홍수정 (가천대학교 길병원 치과보철과) ;
  • 배정윤 (가천대학교 길병원 치과보철과) ;
  • 김현희 (가천대학교 길병원 치과보철과)
  • Received : 2018.04.11
  • Accepted : 2018.06.07
  • Published : 2018.07.31
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: This study was to assess clinically the incidence of abutment screw loosening of posterior implant-supported fixed prosthesis and its affecting factors. Materials and methods: 391 implant-supported crowns restored from January 2013 to January 2016 were included in this study. All restorations were fabricated with either a single crowns or a splinted crown, and cemented with temporary cement. The incidence of abutment screw loosening is investigated and gender, restoration position, opposing teeth, restoration type, abutment connection type were assessed as possible factors affecting abutment screw loosening. Results: During the observation period (2 - 5 years), abutment screw loosening was found in 29 restorations (7.4%). It took 3 to 48 months (means 19.5 months) to loose the screw, and three of these implants were fractured. Among the factors considered, there were statistically significant differences at abutment screw loosening rate between molar group (9.4%) and premolar group (2.6%) (P<.019). According to the type of opposing teeth, there were statistically significant differences between nature teeth (74.7%) and implant (25.0%), removable denture (3%) (P<.019). The other possible factors did not have a significant effect on loosening of the abutment. Conclusion: The incidence of abutment screw loosening in posterior restoration was 7.4%. Abutment screw loosening were more likely to occur in molars group than premolar group, and according to the opposing teeth, there were the greatest frequency in nature teeth than implant and removal denture. There was a statistically significant difference.

목적: 본 연구의 목적은 구치부 식립 임플란트에서 지대주 나사 풀림의 발생 빈도 및 지대주 나사 풀림에 영향을 주는 다양한 요인들을 후향적 연구를 통하여 평가하는 것이다. 대상 및 방법: 2013년 1월부터 2016년 1월까지 208명의 환자에서 구치부에 식립한 391개의 임플란트를 대상으로 하였다. 모든 수복물은 고정성으로 단일 혹은 연결 크라운, 브릿지로 제작되었으며, 임시 시멘트로 합착하였다. 전체 수복물 중 지대주 나사 풀림의 발생 빈도를 조사하였고, 성별, 보철물의 위치, 대합치, 보철물의 유형, 지대주 연결 유형, 매식체의 지름이 지대주 나사 풀림에 미치는 영향을 평가하였다. 결과: 2 - 5년의 관찰 결과, 총 29개(7.4%)의 임플란트에서 지대주 나사 풀림이 발생하였다. 최종 수복 후 지대주 나사 풀림이 발생하기까지 소요된 기간은 3개월부터 48개월(평균19.5개월)까지 다양하게 나타났으며, 이 중 3개의 임플란트에서 매식체의 파절이 발생되었다. 고려 요인들 중, 임플란트의 식립 위치에 따라 대구치(9.4%)와 소구치(2.6%)에서 통계적으로 유의한 차이를 보였으며(P < .019), 대합치에 따라 자연치(9.9%), 임플란트(1.0%), 가철성 보철물(0%)에서 유의한 차이를 보였다(P < .018). 다른 고려 요인에 따른 지대주 나사 풀림 발생 빈도는 통계적 유의성이 없었다. 결론: 구치부 임플란트 수복물에서 지대주 나사 풀림의 발생 빈도는 7.4%로 나타났다. 소구치보다 대구치에서 유의하게 높은 발생 빈도를 보였으며, 대합치에 따라서는 임플란트, 가철성 보철물과 비교 시 자연치에서 유의하게 높은 발생 빈도를 보였다.

Keywords

References

  1. Goodacre CJ, Bernal G, Rungcharassaeng K, Kan JY. Clinical complications with implants and implant prostheses. J Prosthet Dent 2003;90:121-32. https://doi.org/10.1016/S0022-3913(03)00212-9
  2. Misch CE. Contemporary implant dentistry. 3rd ed. St. Louis; Mosby Elsevier; 2008.
  3. Goodacre CJ, Kan JY, Rungcharassaeng K. Clinical compli- cations of osseointegrated implants. J Prosthet Dent 1999;81: 537-52. https://doi.org/10.1016/S0022-3913(99)70208-8
  4. Siamos G, Winkler S, Boberick KG. Relationship between implant preload and screw loosening on implant-supported prostheses. J Oral Implantol 2002;28:67-73. https://doi.org/10.1563/1548-1336(2002)028<0067:TRBIPA>2.3.CO;2
  5. Kourtis S, Damanaki M, Kaitatzidou S, Kaitatzidou A, Roussou V. Loosening of the fxing screw in single implant crowns: predisposing factors, prevention and treatment options. J Esthet Restor Dent 2017;29:233-46. https://doi.org/10.1111/jerd.12303
  6. Taylor TD. Prosthodontic problems and limitations associated with osseointegration. J Prosthet Dent 1998;79:74-8. https://doi.org/10.1016/S0022-3913(98)70197-0
  7. Lekholm U, van Steenberghe D, Herrmann I, Bolender C, Folmer T, Gunne J, Henry P, Higuchi K, Laney WR, Linden U. Osseointegrated implants in the treatment of partially edentulous jaws: A prospective 5-year multicenter study. Int J Oral Maxillofac Implants 1994;9:627-35.
  8. Gunne J, Jemt T, Linden B. Implant treatment in partially edentulous patients: a report on prostheses after 3 years. Int J Prosthodont 1994;7:143-8.
  9. Jemt T, Laney WR, Harris D, Henry PJ, Krogh PH Jr, Polizzi G, Zarb GA, Herrmann I. Osseointegrated implants for single tooth replacement: a 1-year report from a multicenter pro- spective study. Int J Oral Maxillofac Implants 1991;6:29-36.
  10. Simon RL. Single implant-supported molar and premolar crowns: a ten-year retrospective clinical report. J Prosthet Dent 2003;90:517-21. https://doi.org/10.1016/j.prosdent.2003.08.025
  11. Mericske-Stern R, Assal P, Mericske E, Bürgin W. Occlusal force and oral tactile sensibility measured in partially edentulous patients with ITI implants. Int J Oral Maxillofac Implants 1995;10:345-53.
  12. Hekimoglu C, Anil N, Cehreli MC. Analysis of strain around endosseous dental implants opposing natural teeth or im- plants. J Prosthet Dent 2004;92:441-6. https://doi.org/10.1016/j.prosdent.2004.07.023
  13. van Eijden TM. Three-dimensional analyses of human bite- force magnitude and moment. Arch Oral Biol 1991;36:535-9. https://doi.org/10.1016/0003-9969(91)90148-N
  14. Becker W, Becker BE. Replacement of maxillary and man- dibular molars with single endosseous implant restorations: a retrospective study. J Prosthet Dent 1995;74:51-5. https://doi.org/10.1016/S0022-3913(05)80229-X
  15. Freitas-Júnior AC, Almeida EO, Bonfante EA, Silva NR, Coelho PG. Reliability and failure modes of internal conical dental implant connections. Clin Oral Implants Res 2013;24:197-202. https://doi.org/10.1111/j.1600-0501.2012.02443.x
  16. Kitagawa T, Tanimoto Y, Odaki M, Nemoto K, Aida M. Influence of implant/abutment joint designs on abutment screw loosening in a dental implant system. J Biomed Mater Res B Appl Biomater 2005;75:457-63.
  17. Rangert BR, Sullivan RM, Jemt TM. Load factor control for implants in the posterior partially edentulous segment. Int J Oral Maxillofac Implants 1997;12:360-70.
  18. Balshi TJ, Hernandez RE, Pryszlak MC, Rangert B. A comparative study of one implant versus two replacing a single molar. Int J Oral Maxillofac Implants 1996;11:372-8.
  19. Wyatt CC, Zarb GA. Treatment outcomes of patients with implant-supported fxed partial prostheses. Int J Oral Maxillofac Implants 1998;13:204-11.
  20. Kregzde M. A method of selecting the best implant prosthesis design option using three-dimensional fnite element analysis. Int J Oral Maxillofac Implants 1993;8:662-73.
  21. Weinberg LA. The biomechanics of force distribution in implant-supported prostheses. Int J Oral Maxillofac Implants 1993;8:19-31.