Characteristics and Risk Factors for the Fracture of One-Piece Implants

• Published in: Journal of maxillofacial and oral surgery Vol. 22; no. 4; pp. 1091 - 1098
• Main Authors: Fujii, Yasuyuki, Hatori, Ayano, Minami, Sakura, Kanno, Yuki, Hamada, Hayato, Miyazawa, Toshiaki, Chikazu, Daichi
• Format: Journal Article
• Language: English
• Published: New Delhi Springer India 01-12-2023; Springer Nature B.V
• Subjects: Age groups; Dental crowns; Dental implants; Dentistry; Fractures; Medicine; Medicine & Public Health; Metal fatigue; Oral and Maxillofacial Surgery; Original Article; Otorhinolaryngology; Patients; Plastic Surgery; Prostheses; Risk factors; Software; Japan; Dental prosthesis, implant-supported, implant fractures; Implant complications; Dental implant-abutment design; One-piece implants; Dental implant
• ISSN: 0972-8279; 0974-942X
• DOI: 10.1007/s12663-023-02033-z

Objective
The one-piece dental implant was originally designed to overcome the structural weaknesses of the two-piece implant. However, a fractured one-piece implant requires removal because the abutment cannot be repaired or replaced to support new prosthetic restorations. The aim of this study was to clarify the features and risk factors for fracture of the one-piece implant.
Methods
This study was designed as a retrospective case series research. The subjects were patients who were treated for fractures of the one-piece implant at a clinic in Japan between 2012 and 2021. Fractures of the one-piece implant were diagnosed by cone-beam computed tomography, and the association between age and duration from implant placement to fracture was analyzed by one-way ANOVA followed by the Tukey test.
Results
Eighteen patients and 20 one-piece implants (under 39 years: 5 patients and 6 implants; 40–59 years: 7 patients and 7 implants; over 60 years: 6 patients and 7 implants) had fractures in their one-piece implants. Of the fractured implants, 11 had a diameter of 3 mm, and 9 had a diameter of 4 mm. The mean durations up to implant fracture were 662 days in the younger group, 1467 days in the middle group, and 1239 days in older group, and the duration was significantly shorter in the younger group. In addition, 83.3% of fracture implants in the younger group were in the molar region. All fractures of the one-piece implants occurred under the bone margin. Two patients had torus mandibularis, and 1 patient was had bruxism.
Conclusions
One-piece implants in younger patients that are located in the lower molar position are the most susceptible to implant fracture, and the fracture occurred under the bone margin in all cases.