Implant failure

Objectives: To analyze the complications of dental implant treatment in a group of patients with bruxism in comparison with a matched group of non-bruxers. Material and methods: Patients being diagnosed as bruxers were identified within a group of patients consecutively treated with implant-supported prostheses at one specialist clinic, based on the most recent listed sign and symptoms of bruxism according to the International Classification of Sleep Disorders. A diagnostic grading system of " possible, " " probable, " and " definite " sleep or awake bruxism was used, according to a recent published international consensus. A case–control matching model was used to match the bruxers with a group of non-bruxers, based on five variables. Implant-, prosthetic-, and patient-related data were collected, as well as 14 mechanical complications, and compared between groups. Results: Ninety-eight of 2670 patients were identified as bruxers. The odds ratio of implant failure in bruxers in relation to non-bruxers was 2.71 (95% CI 1.25, 5.88). Considering the same number of patients with the same total number of implants equally distributed between groups, the bruxers group had a higher prevalence of mechanical complications in comparison with the non-bruxers group. Conclusions: This study suggests that bruxism may significantly increase both the implant failure rate and the rate of mechanical and technical complications of implant-supported restorations.

Background: Implant supported dental prostheses are increasingly used in dental practice. The article describes causes of bone loss around the dental implant. Moreover, properties of different materials are compared and discussed. The advantages, disadvantages, and biomechanical concept of different implant-abutment connections are presented. The location of connections in relation to the bone level and the influence of microgap between the abutment and implant are described. Additionally, the implant abutments for cemented and screwed prosthetic restorations are compared. The influence of implant and abutment surface at the transmucosal level on peri-implant soft tissue is discussed. Finally, the biological aspect of abutment-implant connection is analyzed.

Objective: The aim of this systemic review is to study bone loss factors around oral implants after first year.

Methods and Materials: A systemic research was conducted on PubMed, Google Scholar, and International Journal of Implant Dentistry in Nov. 2021 with the following keywords: oral implants and marginal bone resorption/crestal bone loss/bone loss/bone resorption. This search resulted in a total of one thousand seven hundred fifty-seven papers. Further search and filtering based on inclusion criteria finally resulted in 12 studies, which were reviewed.

Result: Ten publications fulfilled the inclusion criteria. Two studies evaluated the influence of implant surface characteristics and two studies reported on the effect of implant design on MBL changes. Six publications analyzed the combined effect of different implant surfaces and designs on MBL alterations. Meanwhile, these studies fucose on patient characteristics, and clinical handling as well. As revealed from available studies, there is no evidence that modified surfaces are superior to non-modified implant surfaces in marginal bone preservation. One study reported on significantly improved MBL preservation for implants with a conical and micro-threaded marginal collar than implants with a cylindrical and non-threaded marginal portion after 3 years in function. No implant system was found to be superior in marginal bone preservation.
Clinical evidence was presented that the so-called combined factors (implant hardware, clinical handling, and patient characteristics) may lead to marginal bone resorption. However, once tissue damage has been caused by combined factors, inflammation and/or infection may develop secondarily and then result in peri-implantitis that may need particular clinical treatment.

Conclusion: As marginal bone loss primarily depends on numerous background factors, it seems logical that, for example, the use of poorly constructed implants placed and handled by untrained clinicians may result in high numbers of patients with secondary problems in form of peri-implantitis; having said this, control of combined factors may likewise lead to very good clinical results where peri-implantitis would represent a very rare disease indeed even at follow-up times of 10 years or more. So, in short that can be said that all the factors and reasons that lead to bone resorption around dental implants are a matter of several factors that are relevant to both the doctor, the patient, and the implant system and its materials.

Objectives
Despite vertiginous success and impressive satisfaction from dental implants, the issue of implant failure still creates a major concern for dental operators.
Clinical Considerations
Clinical exhibitions of implant overload are varying from the abrasion, deformation, crack or fracture of various parts of the superstructure prosthesis and/or various parts of the fixture, abutment and main screw, to the inflammatory response and/or infectious changes of periimplant soft tissues including host bone. Disintegration of the implant from the surrounding bone and the ending of the implant-supported prosthesisʼ service should also be considered in implant overload.
Conclusions
Various clinical exhibitions of dental implant overload have been discussed in present paper.
Clinical Significance
Kinds, etiologic factors and precautions of the failures affecting implants, incorporated prostheses and connecting elements are important in order to establish the long-term reliable service for implant-consisting prosthodontic treatments.

Dental implants offer excellent tooth replacement options however; peri-implantitis can limit their clinical success by causing failure. Peri-implantitis is an inflammatory process around dental implants resulting in bone loss in association with bleeding and suppuration. Dental plaque is at the center of its etiology, and in addition, systemic diseases, smoking, and parafunctional habits are also implicated. The pathogenic species associated with peri-implantitis include, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, and Tannerella
forsythia. The goal in the management of peri-implantitis is the complete resolution of peri-implant infection with function. Therapies using various biomaterials to deliver antibiotics have been used in the treatment of peri-implantitis e.g. fibers, gels, and beads. The use of
guided tissue regeneration barrier membranes loaded with antimicrobials has shown success in re-osseointegrating the infected implants in animal models. Several uncertainties still remain regarding the management of peri-implantitis. The purpose of this article is to present a background of peri-implantitis along with a case of peri-implantitis successfully treated for bone regeneration.

Recent studies have suggested that the insertion of dental implants in patients being diagnosed with bruxism negatively affected the implant failure rates. The aim of the present study was to investigate the association between the bruxism and the risk of dental implant failure. This retrospective study is based on 2670 patients who received 10096 implants at one specialist clinic. Implant- and patient-related data were collected. Descriptive statistics were used to describe the patients and implants. Multilevel mixed effects parametric survival analysis was used to test the association between bruxism and risk of implant failure adjusting for several potential confounders. Criteria from a recent international consensus (Lobbezoo et al., J Oral Rehabil, 40, 2013, 2) and from the International Classification of Sleep Disorders (International classification of sleep disorders, revised: diagnostic and coding manual, American Academy of Sleep Medicine, Chicago, 2014) were used to define and diagnose the condition. The number of implants with information available for all variables totalled 3549, placed in 994 patients, with 179 implants reported as failures. The implant failure rates were 13.
0% (24/185) for bruxers and 4.
6% (155/3364) for non-bruxers (P < 0
.001). The statistical model showed that bruxism was a statistically significantly risk factor to implant failure (HR 3.
396; 95% CI 1
.314, 8
.777; P = 0.
012), as well as implant length, implant diameter, implant surface, bone quantity D in relation to quantity A, bone quality 4 in relation to quality 1 (Lekholm and Zarb classification), smoking and the intake of proton pump inhibitors. It is suggested that the bruxism may be associated with an increased risk of dental implant failure.

Interlocking nails are widely used implants in the management of long-bone diaphyseal fractures. Interlocking nailing is an easy, predictable, and
standard method owing to the presence of ancillary instruments and image intensifier. Proximal jigs help in guiding and inserting nail as well as its
proximal locking. Intraoperative breakage of proximal jig may be an uncommon problem that is underreported in the literature. The creative use
of variable unrelated instruments may prove instrumental to manage the complication and result in safe surgery. We describe one such uncommon
intraoperative failure of proximal jig during femoral interlocking procedure and our experience in getting past the hurdle by an innovative solution.
Keywords: Complication, injury, instrument breakage, interlocking nail, intraoperative complication, treatment

BACKGROUND:
The articular surface replacement (ASR) was recalled in 2010 because of higher than expected revision rates. Patients reported symptoms of neurologic dysfunction including poor vision. This cohort study, using objective measurements, aimed to establish whether a higher incidence of visual function defects exists in ASR patients.
METHODS:
Thirty-three ASR patients and 33 non-ASR controls (control 1) were recruited. Data were compared with normative population data from the visual electrophysiology database (control 2). Patients underwent investigations for serum cobalt levels, psychophysical visual tests, and extensive electrophysiological visual testing.
RESULTS:
After excluding 2 subjects with pre-existing eye disease, data from 33 ASR patients were compared with the 2 control cohorts. The median serum cobalt level in the ASR group (median, 52 nmol/L [interquartile range, 14-151 nmol/L]) was significantly higher than that in the control 1 cohort (median, 7 nmol/L [interquartile range, 5-14 nmol/L]; P < .0001). The photoreceptor function of patients with an ASR of the hip showed significantly larger electroretinography mixed rod-cone b-wave amplitudes than both control 1 and control 2 cohorts (P = .0294 and .0410, respectively). Abnormalities in macular function as reflected by multifocal and scotopic electroretinography were more prevalent in control 1 (P = .0445 and .0275, respectively). Optic nerve pathway measurements using visual-evoked potential latency was significantly longer in the ASR group compared with those in the control 2 cohort (P = .0201). There were no statistical differences in visual acuity.
CONCLUSION:
A statistically significant disturbance in visual electrophysiology was found in the ASR group when compared with the control groups. These differences did not translate to identifiable clinical visual deficits. Orthopedic surgeons need to be aware of the possibility of visual dysfunction in patients with ASR and other metal-on-metal hip arthroplasties; however, routine visual testing is not recommended.

Objectives: To assess the survival of dental implants placed in sites of previously failed implants and to explore the possible factors that might affect the outcome of this reimplantation procedure. Materials and methods: Patients that had failed dental implants, which were replaced with the same implant type at the same site, were included. Descriptive statistics were used to describe the patients and implants; survival analysis was also performed. The effect of systemic, environmental, and local factors on the survival of the reoperated implants was evaluated. Results: 175 of 10,096 implants in 98 patients were replaced by another implant at the same location (159, 14, and 2 implants at second, third, and fourth surgeries, respectively). Newly replaced implants were generally of similar diameter but of shorter length compared to the previously placed fixtures. A statistically significant greater percentage of lost implants were placed in sites with low bone quantity. There was a statistically significant difference (P = 0.032) in the survival rates between implants that were inserted for the first time (94%) and implants that replaced the ones lost (73%). There was a statistically higher failure rate of the reoperated implants for patients taking antidepressants and antithrombotic agents. Conclusions: Dental implants replacing failed implants had lower survival rates than the rates reported for the previous attempts of implant placement. It is suggested that a site-specific negative effect may possibly be associated with this phenomenon, as well as the intake of antidepressants and antithrombotic agents.