PubMed · 9511525
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R P Kernott. 1993. Maxillary-mandibular: formational dynamics.. https://pubmed.ncbi.nlm.nih.gov/9511525/
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STATEMENT OF PROBLEM: There is no comprehensive review of the literature that identifies the complications reported in clinical dental implant studies. PURPOSE: This article attempted to determine the types of complications that have been reported and to provide data regarding their frequency. METHODS: All available clinical studies from 1981 to 1997, published in English or with English abstract, that presented success/failure data regarding implant treatment were evaluated to determine the types of reported complications and to quantify implant loss as it relates to type of prosthesis, arch, time, implant length, and bone quality. RESULTS: Greater implant loss occurred with overdentures than with other types of prostheses. There was greater loss in the maxilla than mandible with fixed complete dentures and overdentures, whereas little arch difference was noted with fixed partial dentures. Implant loss increased with short implants and poor bone quality. The time of implant loss (preprosthetic vs postprosthetic) varied with type of prosthesis. Surgical complications included neurosensory disturbance, hematoma, mandibular fracture, hemorrhage, and tooth devitalization. Initial and long-term marginal bone changes were identified. Peri-implant soft tissue complications included dehiscence, fistulas, and gingival inflammation/proliferation. Mechanical complications were screw loosening/fracture, implant fractures, framework, resin base and veneering material fractures, opposing prosthesis fractures, and overdenture mechanical retention problems. Some studies also presented phonetic and esthetic complications. CONCLUSIONS: Although the literature presents considerable information on implant complications, variations in study design and reporting procedures limited the available data and therefore precluded proper analysis of certain complications.
A study of the literature reveals a variety of opinions on the potential for change in arch dimensions. The variations in sample sizes, treatment mechanics, and retention regimens may obscure relevant findings. These articles confirm some common findings, and a number of clinical cases are presented to illustrate these trends. It would seem that limited degrees of arch expansion can be produced regularly, but careful case selection is necessary. Arch expansion is most likely to be achieved in the growing patient with correction of crossbites, correction of a Class II malocclusion, and achievement of a good intercuspation without extractions.
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