Imaging Science in Dentistry

Korean Academy of Oral and Maxillofacial Radiology (대한영상치의학회)
권호 표지
DOI QR코드

DOI QR Code

The occurrence of dental implant malpositioning and related factors: A cross-sectional cone-beam computed tomography survey

  • Safi, Yaser (Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences) ;
  • Amid, Reza (Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences) ;
  • Zadbin, Fariba (School of Dentistry, Shahid Beheshti University of Medical Sciences) ;
  • Ahsaie, Mitra Ghazizadeh (Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences) ;
  • Mortazavi, Hamed (Department of Oral Medicine, School of Dentistry, Shahid Beheshti University of Medical Sciences)
  • Received : 2020.12.17
  • Accepted : 2021.02.24
  • Published : 2021.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: Dental implants are widely used for the rehabilitation of edentulous sites. This study investigated the occurrence of dental implant malpositioning as shown on post-implantation cone-beam computed tomography (CBCT) and to identify related factors. Materials and Methods: Samples with at least 1 malpositioned dental implant were collected from a central radiology clinic in Tehran, Iran from January 2017 to January 2019. Variables such as demographic characteristics, length and diameter of implants, type of implant, sites of implant insertion, different types of implant malpositioning problems (cortical plate perforation, interference with anatomical structures), angulation of the implant, and the severity of malpositioning were assessed. In addition, the incidence of implant fracture and over-drilling was evaluated. Data were statistically analyzed using the chi-square test, 1-sample t-test, and Spearman correlation coefficients. Results: In total, 252 patients referred for implant postoperative CBCT evaluations were assessed. The cases of implant malpositioning included perforation of the buccal cortical plate (19.4%), perforation of the lingual cortical plate (14.3%), implant proximity to an adjacent implant (19.0%), implant proximity to an adjacent tooth (3.2%), interference with anatomical structures(maxillary sinus: 18.3%, mandibular canal: 11.1%, nasal cavity: 6.3%, mental foramen: 5.6%, and incisive canal: 0.4%). Implant fracture and over-drilling were found in 1.6% and 0.8% of cases, respectively. Severity was categorized as mild (9.5%), moderate (35.7%), severe (37.7%), and extreme (17.1%), and 52.4% of implants had inappropriate angulation. Conclusion: CBCT imaging is recommended for detecting dental implant malpositioning. The most common and severe type of malpositioning was buccal cortex perforation.

Keywords

References

  1. Misch K, Wang HL. Implant surgery complications: etiology and treatment. Implant Dent 2008; 17: 159-68. https://doi.org/10.1097/ID.0b013e3181752f61
  2. McDermott NE, Chuang SK, Woo VV, Dodson TB. Complications of dental implants: identification, frequency, and associated risk factors. Int J Oral Maxillofac Implants 2003; 18: 848-55.
  3. Palma-Carrio C, Maestre-Ferrin L, Penarrocha-Oltra D, Penarrocha-Diago MA, Penarrocha-Diago M. Risk factors associated with early failure of dental implants. A literature review. Med Oral Patol Oral Cir Bucal 2011; 16: e514-7.
  4. Ko YC, Huang HL, Shen YW, Cai JY, Fuh LJ, Hsu JT. Variations in crestal cortical bone thickness at dental implant sites in different regions of the jawbone. Clin Implant Dent Relat Res 2017; 19 : 440-6. https://doi.org/10.1111/cid.12468
  5. Dubois L, de Lange J, Baas E, Van Ingen J. Excessive bleeding in the floor of the mouth after endosseus implant placement: a report of two cases. Int J Oral Maxillofac Surg 2010; 39: 412-5. https://doi.org/10.1016/j.ijom.2009.07.062
  6. Esposito M, Thomsen P, Ericson LE, Lekholm U. Histopathologic observations on early oral implant failures. Int J Oral Maxillofac Implants 1999; 14: 798-810.
  7. Liaw K, Delfini RH, Abrahams JJ. Dental implant complications. Semin Ultrasound CT MR 2015; 36: 427-33. https://doi.org/10.1053/j.sult.2015.09.007
  8. Jaju P, Jaju S. Lingual vascular canal assessment by dental computed tomography: a retrospective study. Indian J Dent Res 2011; 22: 232-6. https://doi.org/10.4103/0970-9290.84293
  9. Longoni S, Sartori M, Braun M, Bravetti P, Lapi A, Baldoni M, et al. Lingual vascular canals of the mandible: the risk of bleeding complications during implant procedures. Implant Dent 2007; 16: 131-8. https://doi.org/10.1097/ID.0b013e31805009d5
  10. Abas I, Meijer GJ. Implant positioned buccally of the alveolar process; a complication. Ned Tijdschr Tandheelkd 2016; 123: 79-81. https://doi.org/10.5177/ntvt.2016.02.15143
  11. Shelley AM, Ferrero A, Brunton P, Goodwin M, Horner K. The impact of CBCT imaging when placing dental implants in the anterior edentulous mandible: a before-after study. Dentomaxillofac Radiol 2015; 44: 20140316. https://doi.org/10.1259/dmfr.20140316
  12. Chang E. Dental implants. In: Mallya SM, Lam EW. White and Pharoah's oral radiology: principles and interpretation. 8th ed. St. Louis: Elsevier; 2019. p. 248-70.
  13. Moy PK, Medina D, Shetty V, Aghaloo TL. Dental implant failure rates and associated risk factors. Int J Oral Maxillofac Implants 2005; 20: 569-77.
  14. Chuang SK, Wei LJ, Douglass CW, Dodson TB. Risk factors for dental implant failure: a strategy for the analysis of clustered failure-time observations. J Dent Res 2002; 81: 572-7. https://doi.org/10.1177/154405910208100814
  15. Mohajerani H, Roozbayani R, Taherian S, Tabrizi R. The Risk factors in early failure of dental implants: a retrospective study. J Dent(Shiraz) 2017; 18: 298-303.
  16. Alsaadi G, Quirynen M, Michiles K, Teughels W, Komarek A, van Steenberghe D. Impact of local and systemic factors on the incidence of failures up to abutment connection with modified surface oral implants. J Clin Periodontol 2008; 35: 51-7. https://doi.org/10.1111/j.1600-051X.2007.01165.x
  17. van Steenberghe D, Jacobs R, Desnyder M, Maffei G, Quirynen M. The relative impact of local and endogenous patient-related factors on implant failure up to the abutment stage. Clin Oral Implants Res 2002; 13: 617-22. https://doi.org/10.1034/j.1600-0501.2002.130607.x
  18. Sverzut AT, Stabile GA, de Moraes M, Mazzonetto R, Moreira RW. The influence of tobacco on early dental implant failure. J Oral Maxillofac Surg 2008; 66: 1004-9. https://doi.org/10.1016/j.joms.2008.01.032
  19. Noguerol B, Munoz R, Mesa F, de Dios Luna J, O'Valle F. Early implant failure. Prognostic capacity of Periotest: retrospective study of a large sample. Clin Oral Implants Res 2006; 17: 459-64. https://doi.org/10.1111/j.1600-0501.2006.01250.x
  20. O'Sullivan D, Sennerby L, Meredith N. Influence of implant taper on the primary and secondary stability of osseointegrated titanium implants. Clin Oral Implants Res 2004; 15: 474-80. https://doi.org/10.1111/j.1600-0501.2004.01041.x
  21. Parein AM, Eckert SE, Wollan PC, Keller EE. Implant reconstruction in the posterior mandible: a long-term retrospective study. J Prosthet Dent 1997; 78: 34-42. https://doi.org/10.1016/S0022-3913(97)70085-4
  22. Adell R, Eriksson B, Lekholm U, Branemark PI, Jemt T. Longterm follow-up study of osseointegrated implants in the treatment of totally edentulous jaws. Int J Oral Maxillofac Implants 1990; 5: 347-59.
  23. Buser D, Mericske-Stern R, Bernard JP, Behneke A, Behneke N, Hirt H, et al. Long term evaluation of non-submerged ITI implants. Part 1: 8-year life table analysis of a prospective multi-center study with 2359 implants. Clin Oral Implants Res 1997; 8: 161-72. https://doi.org/10.1034/j.1600-0501.1997.080302.x
  24. Safi Y, Amid R, Vasegh Z, Ghazizadeh Ahsaie M. Anatomical variations in the interforaminal regions of candidates for implantassisted overdentures: a cross-sectional CBCT analysis. Gen Dent 2020; 68: 11-6.
  25. Kalpidis CD, Konstantinidis AB. Critical hemorrhage in the floor of the mouth during implant placement in the first mandibular premolar position: a case report. Implant Dent 2005; 14: 117-24. https://doi.org/10.1097/01.id.0000165028.89434.99
  26. Kim SG, Mitsugi M, Kim BO. Simultaneous sinus lifting and alveo-lar distraction of the atrophic maxillary alveolus for implant placement: a preliminary report. Implant Dent 2005; 14: 344-8. https://doi.org/10.1097/01.id.0000188381.24406.35
  27. Shin HI, Sohn DS. A method of sealing perforated sinus membrane and histologic finding of bone substitutes: a case report. Implant Dent 2005; 14: 328-35. https://doi.org/10.1097/01.id.0000188465.93052.cd
  28. Ellies LG, Hawker PB. The prevalence of altered sensation associated with implant surgery. Int J Oral Maxillofac Implants 1993; 8: 674-9.
  29. Burstein J, Mastin C, Le B. Avoiding injury to the inferior alveolar nerve by routine use of intraoperative radiographs during implant placement. J Oral Implantol 2008; 34: 34-8. https://doi.org/10.1563/1548-1336(2008)34[34:AITTIA]2.0.CO;2
  30. Griffin TJ, Cheung WS. The use of short, wide implants in posterior areas with reduced bone height: a retrospective investigation. J Prosthet Dent 2004; 92: 139-44. https://doi.org/10.1016/j.prosdent.2004.05.010
  31. Doh RM, Pang NS, Kim KD, Park W. Implant displacement into the mandible: an unusual complication during implant surgery. Implant Dent 2011; 20: 345-8. https://doi.org/10.1097/ID.0b013e3182326813
  32. Hurzeler MB, Kirsch A, Ackermann KL, Quinones CR. Reconstruction of the severely resorbed maxilla with dental implants in the augmented maxillary sinus: a 5-year clinical investigation. Int J Oral Maxillofac Implants 1996; 11: 466-75.
  33. Jung JH, Choi BH, Zhu SJ, Lee SH, Huh JY, You TM, et al. The effects of exposing dental implants to the maxillary sinus cavity on sinus complications. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006; 102: 602-5. https://doi.org/10.1016/j.tripleo.2005.10.061
  34. Misch C. Maxillary sinus augmentation for endosteal implants: organized alternative treatment plans. Int J Oral Implantol 1987; 4: 49-58.
  35. Raghoebar GM, Vissink A. Treatment for an endosseous implant migrated into the maxillary sinus not causing maxillary sinusitis: case report. Int J Oral Maxillofac Implants 2003; 18: 745-9.
  36. Lim D, Parumo R, Chai MB, Shanmuganathan J. Transnasal endoscopy removal of dislodged dental implant: a case report. J Oral Implantol 2017; 43: 228-31. https://doi.org/10.1563/aaid-joi-D-16-00172
  37. Ribas BR, Nascimento EH, Freitas DQ, Pontual AD, Pontual ML, Perez DE, et al. Positioning errors of dental implants and their associations with adjacent structures and anatomical variations: a CBCT-based study. Imaging Sci Dent 2020; 50: 281-90. https://doi.org/10.5624/isd.2020.50.4.281
  38. Shelley AM, Brunton P, Horner K. Subjective image quality assessment of cross sectional imaging methods for the symphyseal region of the mandible prior to dental implant placement. J Dent 2011; 39: 764-70. https://doi.org/10.1016/j.jdent.2011.08.008
  39. Quirynen M, Mraiwa N, Van Steenberghe D, Jacobs R. Morphology and dimensions of the mandibular jaw bone in the interforaminal region in patients requiring implants in the distal areas. Clin Oral Implants Res 2003; 14: 280-5. https://doi.org/10.1034/j.1600-0501.2003.140305.x
  40. Safi Y, Amid R, Vasegh Z, Ahsaie MG. A new classification of anterior mandible edentulous ridge based on cone beam computed tomography. J Long Term Eff Med Implants 2021; 31: 21-31.