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Mechanical complications of dental implants.

Adverse occlusal forces can result in mechanical complications of implant components. While unacceptably high incidences of mechanical failures have been reported for the two-stage external hex screw-type implant systems, the standard-diameter ITI solid-screw implant does not seem to be vulnerable to these problems. The 8 degrees Morse taper has eliminated abutment screw loosening and fracture. The incidence of prosthetic screw loosening has been minimized by the 45 degrees bevel on the implant shoulder and by the 1.5 mm vertical abutment walls. The design of the standard-diameter solid-screw ITI implant and the material used in its fabrication (cold worked type IV cp titanium) have eliminated fixture fracture. However, because there have been some reported instances of fractures involving reduced-diameter and hollow implants, these designs should be used with caution.

Dental Implants↗

The longitudinal clinical effectiveness of osseointegrated dental implants in posterior partially edentulous patients.

While considerable data have been published on the use of the osseointegration technique in the anterior region of the edentulous mouth, there remains scant information on its success in the posterior areas of either the maxillae or mandible. This prospective study was begun in the mid-1980s to test the effectiveness of this technique in the treatment of partially edentulous posterior areas of the maxillae and mandible, and in situations where the implant-supported prosthesis carries a significant portion of the total occlusal load. One hundred five implants were placed into 46 edentulous areas in 35 patients. After periods of loaded service ranging from 2.6 to 7.4 years (mean 5.2 years), of the 41 implants placed in maxillae, 40 (97.6%) remain in function, and of the 64 placed in mandibles, 59 (92.2%) remain in function. The overall implant survival rate of 94.3% suggests that partially edentulous areas in the posterior zones of either arch can be treated prosthodontically using osseointegrated implants with predictable success.

Adult↗

Esthetic and biomechanical considerations in reconstructions using dental implants.

The single-tooth implant-supported restoration can provide an outstanding service to many patients. It requires an understanding of the biomechanical principles involved and attention to the many details involved with the diagnosis and treatment planning for these restorations. The clinician should realize that this restorative approach is contraindicated in many circumstances. As Peter K. Thomas said, "Spend more time planning than doing and doing becomes easier."

Dental Abutments↗

Tightening characteristics for screwed joints in osseointegrated dental implants.

The significance of tightening abutment screws and gold cylinders to osseointegrated fixtures with the correct torque is demonstrated, and a simple relationship between applied torque and screw preload is derived by use of mechanical engineering principles. The principles of a number of tightening methods are outlined and assessments made of their accuracy. The difference between optimum and design torque is highlighted. The necessity and means of achieving optimum torque to ensure a reliable joint in clinical practice is discussed.

Dental Abutments↗

Reconstruction of a severely atrophic maxilla using a Le Fort I downgraft and dental implants: clinical report.

A 55-year-old woman developed chronic infections of the maxillary sinuses with osteomyelitis resulting in extensive bone destruction and atrophy from a failed subperiosteal implant. After surgical removal of the subperiosteal implant, extensive debridement of the maxilla, and long-term antibiotic therapy, maxillary reconstruction was initiated. A Le Fort I osteotomy and downgraft was performed, and a posterior iliac bone graft was harvested and grafted to reconstruct the severely atrophic maxilla. In a later surgical procedure, maxillary and mandibular implants were placed. Implant-retained overdentures were fabricated to restore function and esthetics.

Alveolar Bone Loss↗

Dental implants.

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American Dental Association↗

A 3-year prospective clinical and radiologic analysis of early loaded maxillary dental implants supporting single-tooth crowns.

In this study, 19 patients were treated with 36 Brånemark System MK III TiUnite implants in the maxilla. Definitive implant-supported single crowns were delivered to patients 6 weeks after implant placement. Clinical and radiographic parameters were recorded at baseline, and at 1, 2, and 3 years. Both implant and prosthesis success rates were 94% after 3 years. The average marginal bone loss was 0.97 mm after 3 years. The results of this study indicate that 6-week early loading of TiUnite surface implants in the maxilla was reliable and predictable for this patient population and may offer an alternative to the standard loading protocol.

Adult↗