• Title/Summary/Keyword: Failure of dental implant

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Clinical factors affecting the longevity of fixed retainers and the influence of fixed retainers on periodontal health in periodontitis patients: a retrospective study

  • Han, Ji-Young;Park, Seo Hee;Kim, Joohyung;Hwang, Kyung-Gyun;Park, Chang-Joo
    • Journal of Periodontal and Implant Science
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    • v.51 no.3
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    • pp.163-178
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    • 2021
  • Purpose: The aim of this study was to evaluate clinical factors affecting the longevity of fixed retainers and the influence of fixed retainers on periodontal health in periodontitis patients. Methods: In total, 52 patients with at least 2 years of follow-up after periodontal and orthodontic treatment were included in this study. After scaling and root planing, orthodontic treatment with fixed appliances or clear aligners was performed. Fixed retainers with twist-flex stainless steel wires were bonded to the palatal or lingual sides of anterior teeth. Changes in clinical parameters, including the plaque index, gingival index, calculus index (CI), probing pocket depth, and radiographic bone levels, were evaluated before bonding of fixed retainers and at a 12-month follow-up. Cumulative survival rates (CSRs) for retainer failure were evaluated according to sex, site, CI, stage of periodontitis, and the severity of the irregularity with the log-rank test and hazard ratios (HRs). Results: Twelve months after bonding of fixed retainers, improvements were observed in all clinical parameters except CI and radiographic bone gain. The overall CSR of the retainers with a CI <1 at the 12-month follow-up after bonding of fixed retainers was significantly higher than that of the retainers with a CI ≥1 at the 12-month follow-up (log-rank test; P<0.001). Patients with stage III (grade B or C) periodontitis had a higher multivariate HR for retainer failure (5.4; 95% confidence interval, 1.22-23.91; P=0.026) than patients with stage I (grade A or B) periodontitis. Conclusions: Although fixed retainers were bonded in periodontitis patients, periodontal health was well maintained if supportive periodontal treatment with repeated oral hygiene education was provided. Nonetheless, fixed retainer failure occurred more frequently in patients who had stage III (grade B or C) periodontitis or a CI ≥1 at 12-month follow-up after bonding of fixed retainers.

Optimized Implant treatment strategy based on a classification of extraction socket defect at anterior area (전치부에서 발치와 골결손부에 따른 최적의 심미를 얻을 수 있는 수술법)

  • Ban, Jae-Hyuk
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.25 no.1
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    • pp.15-24
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    • 2016
  • It is considered an implant failure when there is esthetic problems in the anterior area although the prosthesis function normally. In 2003, Dr. Kan et al stated that implant bone level is determined by the adjacent teeth. After that many scholars have studied how can achieve the esthetics result on adjacent teeth bone loss cases. In 2012, Dr. Takino published an article in Quintessence. He summarized previous articles and reclassified the defects from class 1 through 4. Class 1 and 2 depicts a situation where there is no bone loss on adjacent teeth. In Class 3 and 4, interproximal bone loss extends to the adjacent tooth. If one side is involved, it is Class 3. If both sides are involved, it is Class 4. The clue for esthetic implant restoration is whether bone loss extends to adjacent tooth or not. If the bone level of adjacent tooth is sound, we can easily achieve the esthetic but the bone level is not sound, the surgery will be complicated and the esthetic result will be unpredictable. So regenerative surgery for adjacent tooth is necessary for long-term maintenance. But the options and process were so complicated, the purpose of this article is to report the method simplify the surgery and gain a similar outcome.

Full mouth rehabilitation of an oligodontia patient with intellectual disability based on shortened dental arch concept: a case report (2급 지적 장애를 가진 환자의 SDA 개념을 적용한 전악 수복 증례)

  • You, Jae-Wook;Heo, Seong-Joo;Kim, Seong-Kyun;Koak, Jai-Young
    • The Journal of Korean Academy of Prosthodontics
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    • v.50 no.4
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    • pp.330-335
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    • 2012
  • Shortened dental arch (SDA) as a treatment goal is the concept that stable occlusion and enough masticatory force can be achieved by restoration to the second premolars when the situation is not favorable. SDA could be applied both natural teeth and implant supported fixed prostheses. This case dealt with a patient who has grade 2 intellectual disability and a lot of missing teeth. Because of intellectual disability, patient cooperation during treatment could not be expected. Therefore every treatment should be done under general anesthesia. In addition to that, ridge resorption around molar area was severe and there were maxillary sinus pneumatization and maxillary sinusitis which increased failure probability. SDA concept was adopted to reduce risk factor and minimize general anesthesia. After the treatment, functional and esthetic improvement was achieved and oral hygiene was fortified by periodic recall check and education.

THE COMPARATIVE EVALUATION USING HATCH REAMER TECHNIQUE AND OSTEOTOME TECHNIQUE IN SINUS FLOOR ELEVATION (상악동저 거상술 시 Osteotome 술식과 Hatch Reamer 술식의 비교평가)

  • Cho, Seong-Woong;Kim, Sang-Jung;Lee, Dong-Keun;Kim, Chin-Soo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.2
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    • pp.154-161
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    • 2010
  • Many edentulous posterior maxilla are found to be compromised by alveolar resorption and increased pneumatization of the sinus. One of the surgical procedures to overcome this anatomical limitation is sinus floor elevation with bone graft, which is reported as more appropriate and more successful procedure. Commonly, if the residual bone height is over 5mm, sinus floor elevation is operated through transcrestal approach using osteotome technique. But, it is possible for patients to feel discomfort during operation and dizziness after operation while malleting, sinus floor elevation, using osteotome technique. Some instruments and methods has been used to overcome these problems and use more easily. The aim of this study is to compare between the surgical procedure of sinus floor elevation using Hatch reamer technique and that of sinus floor elevation using osteotome technique. From 2004 Feb to 2007 Oct, we investigate patients (osteotome group: 72, Hatch reamer group: 70) who were given implant surgery with sinus floor elevation (osteotome group: 92, Hatch reamer group: 98). We analysed gender, age, residual bone height, amount of sinus floor elevation, used graft material, total success rate, failure rate by residual bone height and implant type and discomfort during operation, etc. The results obtained were as follows. 1. In the amount of sinus elevation was osteotome group was $3.85{\pm}1.02\;mm$ and Hatch reamer group was $3.93{\pm}1.38\;mm$. There was no statistically significant difference between the two groups (P > 0.05). 2. At the total success rate, osteotome group was 92.4% and Hatch reamer group was 94.9%. There was no statistically significant difference between the two groups (P > 0.05). 3. On the discomfort during the operation by using numerical rating scale, osteotome group was $2.87{\pm}0.83$ and Hatch reamer group was $1.12{\pm}0.64$. There was statistically significant difference between the two groups (P < 0.05). The Hatch reamer group clinical results was similar to osteotome group and we thought that Hatch reamer technique can overcome the faults of osteotome technique.

Retrospective study on survival, success rate and complication of implant-supported fixed prosthesis according to the materials in the posterior area (구치부 임플란트 지지 고정성 보철물의 재료에 따른 생존율, 성공률 및 합병증에 대한 후향적 연구)

  • Chae, Hyun-Seok;Wang, Yuan-Kun;Lee, Jung-Jin;Song, Kwang-Yeob;Seo, Jae-Min
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.4
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    • pp.342-349
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    • 2019
  • Purpose: The purpose of this study was to retrospectively investigate the survival and success rate of implant-supported fixed prosthesis according to the materials in the posterior area. Other purposes were to observe the complications and evaluate the factors affecting failure. Materials and methods: Patients who had been restored implant prosthesis in the posterior area by the same prosthodontist in the department of prosthodontics, dental hospital, Chonbuk National University, in the period from January 2011 to June 2018 were selected for the study. The patient's sex, age, material, location, type of prosthesis and complications were examined using medical records. The KaplanMeier method was used to analyze the survival and success rate. The Log-rank test was conducted to compare the differences between the groups. Cox proportional hazards model was used to assess the association between potential risk factors and success rate. Results: A total of 364 implants were observed in 245 patients, with an average follow-up of 17.1 months. A total of 5 implant prostheses failed and were removed, and the 3 and 5 year cumulative survival rate of all implant prostheses were 97.5 and 91.0, respectively. The 3 and 5 year cumulative success rate of all implant prostheses were 61.1% and 32.9%, respectively. Material, sex, age, location and type of prosthesis did not affect success rate (P>.05). Complications occurred in the order of proximal contact loss (53 cases), retention loss (17 cases), peri-implant mucositis (12 cases), infraocclusion (4 cases) and so on. Conclusion: Considering a high cumulative survival rate of implant-supported fixed prostheses, regardless of the materials, implant restored in posterior area can be considered as a reliable treatment to tooth replacement. However, regular inspections and, if necessary, repairs and adjustments are very important because of the frequent occurrence of complications.

The Effects of Professional Tooth Cleaning and Plaque Control Instruction on Reduction of Peri-implantitis (전문가치면세정술과 세균막관리교육의 임플란트 주위염 감소 효과)

  • Park, Kyung-Hwa;Han, Gyeong-Soon
    • Journal of dental hygiene science
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    • v.12 no.2
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    • pp.163-170
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    • 2012
  • The purpose of this study was determine the effects of professional tooth cleaning and plaque control instruction(PT & PCI) on reduction of peri-implantitis. A total 80 implant patients were investigated using O'Leary plague index(PI), L${\ddot{o}}$e & Silness gingival index(GI), implant bone loss(BL). While the PT & PCI was conducted by using 'Watanabe method' after scaling for the experimental group, the engine polishing and a plaque control instruction was operated by rolling method after scaling for the control group. The collected data were analyzed with t-test, ANOVA, paired t-test and stepwise multiple regression. PI and GI of the experimental group significantly decreased than the control group(p<0.05). BL, also tended to decreased in the experimental group than the control group(p=0.155). Multiple regression analysis, the factors that was highly correlated with PT & PCI on the PI and GI. According to the implant characteristics, implant location and duration were closely related to PI(p<0.05). Therefore, the PT & PCI is one of the effective methods to reduce the failure caused by the peri-implantitis. Based on this conclusion, that it would be meaningful if the proposed PT & PCI is applied to the oral health management programs of the implant patients.

Alveolar ridge preservation using granulation tissue for esthetic implant restoration on maxillary anterior tooth (상악 전치부의 심미적 임플란트 수복을 위한 육아 조직(Granulation tissue)을 이용한 치조제 보존술)

  • Lee Chang Kyun
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.32 no.1
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    • pp.16-22
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    • 2023
  • Esthetic factors are very important in the success of maxillary anterior implant restoration. However, achieving esthetic results is difficult, especially in cases where periodontitis has resulted in severe alveolar bone loss. In the case of maxillary anterior teeth, the alveolar ridge resorption that begins immediately after tooth extraction interferes with the esthetic implant restoration. Therefore immediate implant placement can be performed to minimize the alveolar ridge resorption. However, in severe bone loss cases, immediate implant placement could result in esthetic failure, and this result might cause irreparable problems. We can also perform alveolar ridge preservation and then place implants later. On JCP published in 2019, there is the consensus of European academy of periodontology on the extraction socket management and the timing of implant placement. This consensus states that alveolar ridge preservation should be considered when there is severe labial bone loss in an esthetically important area such as maxillary anterior region. On performing the alveolar ridge preservation, we cannot obtain the primary wound closure, so secondary wound healing is induced with open membrane technique or soft tissue grafting should be performed for primary wound closure. However, the secondary wound healing can have a negative impact on bone regeneration, and soft tissue grafting such as FGG or CT graft can be burdensome for both patients and dentists. On the other hand, by using the granulation tissue in the extraction socket, primary closure can be achieved without soft tissue grafting. Also some studies have shown that granulation tissue in periodontal defects contains stem cells that may help in tissue regeneration. Based on this, implant restorations were performed on maxillary anterior teeth with severe alveolar bone loss by alveolar ridge preservation using granulation tissue. In spite of the severe bone defect of the extraction socket, relatively esthetic results could be obtained in implant restorations.

The Realities of Smoking among Some College Students and Their Relevant Knowledge (일부 대학생들의 흡연실태 및 지식도)

  • Kim, Jin;Lim, Sun-A
    • Journal of Korean society of Dental Hygiene
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    • v.6 no.4
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    • pp.283-294
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    • 2006
  • The purpose of this study was to examine the state of smoking among some college students, the smoking motivation of smoker students, what made them quit smoking and how they got ready for giving up smoking, as smoking had a huge impact on national health and there was a desperate necessity for preventive antismoking education programs to let students keep away from smoking. After a survey was conducted with self-administered questionnaires from October 1 through November 1, 2006, the responses from 400 students were gathered, and 384 answer sheets were analyzed except 16 incomplete ones. The findings of the study were as follows: 1. By gender, 62.4% of the male students and 28.6% of the female students were smokers, and the state of smoking was statistically significantly different according to their gender(p<0.05). 2. The largest number of the male students, which accounted 44.1%, started smoking in their high school days, and 39.5% of the females did that in middle school. As for a daily mean amount of smoking, 41.8% of the male students, the greatest percentage, smoked 10 to 19 cigarettes a day, and one to nine cigarettes were most common among the females, which represented 57.9 %. But the gap between the two was insignificant(p>0.05). As many as 83.6% of the males and 86.8% of the females had ever attempted to quit it. 3. Concerning awareness of antismoking policies, they felt that a raise in cigarette price would lead to less smoking, and that antismoking advertisement or posters through television or newspaper would deliver the same results as well. There was a statistically significant difference among their awareness(p<0.05). 4. Regarding preparation stage for quitting smoking, 31.3% of the male smokers had no intention to give it up, and 23.2% considered it. 36.7%, the largest percentage, got ready to refrain from it. Among the female smokers, 34.2% had no plans to abstain from smoking, and 36.8% took it into consideration. 23.7% got ready to do that. The females who got ready for that were outnumbered the males who did. 5. As to connections between the state of smoking and relevant knowledge, the students didn't have a good knowledge on that, and a statistically significant difference existed between the smokers and nonsmokers in smoking knowledge. 6. As for knowledge about oral diseases, they were highly cognizant of the relationship of smoking to tooth discoloration, nicotine stomatitis and bad breath, but they didn't know well about its relationship to delayed recovery from dental treatment, implant failure and ozena. Their smoking condition made a statistically significant difference to their knowledge(p<0.05). In the future, sustained research efforts should be channeled into determining how much smoking affects health and concerns oral diseases, and antismoking counseling programs should be prepared to bolster people's awareness of oral health.

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A retrospective statistical analysis of dental implants (치과 임플란트 환자의 통계 분석에 관한 후향적 연구)

  • Zhao, Chun-Ri;Cho, In-Ho;Moon, Eun-Soo
    • The Journal of Korean Academy of Prosthodontics
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    • v.47 no.3
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    • pp.266-272
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    • 2009
  • Statement of problem: The number of edentulous patients is increasing due to an aging society, which leads to increased demands and interests on implant restorations. Implant restorations are an effective treatment method for both complete and partially edentulous patients, and the success rate has been reported to be high. But because of the increased use of implants in various situations have resulted in frequent reports of failures on implant restorations. Various efforts to overcome these failures have been made. Purpose: The aim of this study was to investigate the statistic survival rate of dental implants on patients who were treated at Dankook University Dental Hospital during the past 10 years based on their charts. Materials and methods :The research was made for two different periods of time; The first investigation was for patients from August, 1998 to August, 2003 and the second was for patients from September, 2003 to April, 2007. Information on the number of implants placed, the location and distribution of implants, the duration between the first and second surgery, and the survival rate of implants were investigated from the patients'charts. Results: 1. According to the first investigation, 1680 implants were placed on 612 patients and the second investigation showed 2438 implants placed on 933 patients. Thus a total of 4118 implants on 1545 patients. 2. Among the 1545 patients, 884 patients were male (57.2 %) and 661 patients were female (42.8%). Out of 4118 implants, 1739 implants (42.2%) were placed on the maxilla, and 2379 implants (57.8%) on the mandible. Implants were placed most frequently in the posterior region of the mandible. A total of 2043 implants (53.2%) were placed in this region. 3. According to the first investigation, 57 out of 1680, implants failed, while from the second investigation, 17 out of 2438 implants were reported as failure. In total, 74 implants failed, which results in a 98.2% survival rate. 4. The average duration between the first and the second surgeries in maxillas decreased from 7.4 months to 6.8 months. The duration also decreased from 5.6 months to 5.0 months in mandibles. Conclusion: As shown in the results, the number of placed implants and the survival rate of implants were higher in the second investigation than that of the first investigation. And the time spent after the first surgery to the second surgery was less in the second investigation. Consequently, it can be presumed that the demand and consumption of dental implants as well as the survival rate will increase in the future.

Influence of Implant Fixture-Abutment Connection and Abutment Design on Mechanical Strength (임플란트 고정체-지대주 연결부 및 지대주 디자인이 기계적 강도에 미치는 영향)

  • Chun, Mi-Hyun;Jeong, Chang-Mo;Jeon, Young-Chan;Eom, Tae-Gwan;Yoon, Ji-Hoon
    • Journal of Dental Rehabilitation and Applied Science
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    • v.24 no.3
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    • pp.269-281
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    • 2008
  • Fatigue or overload can result in mechanical problems of implant components. The mechanical strength in the implant system is dependent on several factors, such as screw and fixture diameters, material, and design of the fixture-abutment connection and abutment. In these factors, the last rules the strength and stability of the fixture-abutment assembly. There have been some previous reports on the mechanical strength of the fixture-abutment assembly with the compressive bending test or short-term cyclic loading test. However, it is restrictive to predict the long-term stability of the implant system with them. The purpose of this study was to evaluate the influence of the design of the fixture-abutment connection and abutment on the mechanical strength and failure mode by conducting the endurance limit test as well as the compressive bending strength test. Tests were performed according to a specified test(ISO/FDIS 14801) in 4 fixture-abutment assemblies of the Osstem implant system: an external butt joint with Cemented abutment (group BJT), an external butt joint with Safe abutment (group BJS), an internal conical joint with Solid abutment (group CJO), and an internal conical joint with ComOcta abutment (group CJT). The following conclusions were drawn within the limitation of this study. Compressive bending strengths were decreased in order of group BJS(1392.0N), group CJO(1261.8N), group BJT(1153.2N), and group CJT(1110.2N). There were no significant differences in compressive bending strengths between group BJT and group CJT(P>.05). Endurance limits were decreased in order of group CJO(600N), group CJT(453N), group BJS(360N), and group BJT(300N). 3. Compressive bending strengths were influenced by the connection and abutment design of the implant system, however endurance limits were affected more considerably by the connection design.