J Dent Rehabil Appl Sci.  2015 Dec;31(4):349-357. 10.14368/jdras.2015.31.4.349.

Prosthodontic problems and complications associated with osseointegration

• Shin SY

• KMID: 2150199
• DOI: http://doi.org/10.14368/jdras.2015.31.4.349

Abstract

Edentulous patients with a severely resorbed mandible or maxilla often experience problems with conventional dentures, such as insufficient stability and retention, together with a decrease in chewing ability. Because of the good prognosis of dental implants, these patients can be successfully treated with implant-retained or implant-supported prosthesis. Ideally, a maximum number of implants of maximum length are placed in appropriate surgically prepared sites that are surrounded by a maximum amount of bone of favorable quality. The implants are favorably aligned faciolingually and mesiodistally to enhance optimal prosthodontic design. This article describes the clinical problems and complications encountered when treating a consecutive number of edentulous patients with osseointegrated implant-supported prostheses.

Keyword

implant; osseointegration; prosthodontic complications; prosthodontic problems

MeSH Terms

Dental Implants
Dentures
Humans
Mandible
Mastication
Maxilla
Osseointegration*
Prognosis
Prostheses and Implants
Prosthodontics*
Dental Implants

Figure

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  Fig. 1 (A) Implant failure. The causes of late implant failure include plaque-induced peri-implantitis, inadequate support from poor quality bone, misfit of prosthesis, occlusion, nonaxial loading, cantilever overload, and others, (B) Buccal, (C) Ligunal views.

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  Fig. 2 Single implant prosthesis in the posterior part in partially edentulous situation. After insertion of final prosthesis, prosthesis screw were badly abraded and had to be replaced.

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  Fig. 3 Implant fracture. (A) Implants supported by bone at insertion of final prosthesis, (B, C) After extraction of remaining teeth, occlusal overload caused bone resorption that reduced the support of the implant and resulted in greater susceptibility to fracture, (D) After removal of fractured implants and reimplantion, and (E) After removal of fractured implants and reimplantion.

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  Fig. 4 Screw fracture by deficiency of bone supporting. (A) After insertion of final prosthesis, (B, C) Recurrent prosthesis-retaining screws fractures resulted from combination of factors that included an unfavorable bone support in the severely resorbed maxilla, implants prosthesis may be subjected to excessive masticatory forces.

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  Fig. 5 (A, B) Bone loss around the fixtures were observed. Bar attachment fracture occurred by unfavorable bone support around implants, (C) Buccal view, (D) Occlusal view.

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  Fig. 6 (A) Patient complained about food impaction between crowns, (B) The implant prosthesis shows failure in solder joint.

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  Fig. 7 Magnetic attachment failure of implant overdenture.

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  Fig. 8 Prosthesis-retaining screw loosening. Rotated crown was observed on occlusal view (A) and panoramic view (B).

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  Fig. 9 Improper implant placement can result in framework design that compromises esthetics and distribution of force on implants. (A) Fixtures placed too close together may prevent the active use of a fixture in the final prosthesis design, (B) Fixtures placed in buccal version preclude generation of occlusal forces in the long axis of the fixture.

Reference

References

1. Adell R, Lekholm U, Rockler B, Brånemark PI. A 15-year study of osseointegrated implants in the treatment of the edentulous jaw. Int J Oral Surg. 1981; 10:387–416. DOI: 10.1016/S0300-9785(81)80077-4.

2. Albrektsson T, Dahl E, Enbom L, Engevall S, Engquist B, Eriksson AR, Feldmann G, Freiberg N, Glantz PO, Kjellman O, Kristersson L, Kvint S, Kondell PA, Palmquist J, Werndahl L, Astrand P. Osseointegrated oral implants. A Swedish multicenter study of 8139 consecutively inserted Nobelpharma implants. J Periodontol. 1988; 59:287–96. DOI: 10.1902/jop.1988.59.5.287. PMID: 3290429.

3. Albrektsson T. A multicenter report on osseointegrated oral implants. J Prosthet Dent. 1988; 60:75–84. DOI: 10.1016/0022-3913(88)90355-1.

4. Johansson G, Palmqvist S. Complications, supplementary treatment, and maintenance in edentulous arches with implant-supported fixed prostheses. Int J Prosthodont. 1990; 3:89–92. PMID: 2196896.

5. Lindquist LW, Rockler B, Carlsson GE. Bone resorption around fixtures in edentulous patients treated with mandibular fixed tissue-integrated prostheses. J Prosthet Dent. 1988; 59:59–63. DOI: 10.1016/0022-3913(88)90109-6.

6. Ogiso M, Tabata T, Kuo PT, Borgese D. A histologic comparison of the functional loading capacity of an occluded dense apatite implant and the natural dentition. J Prosthet Dent. 1994; 71:581–8. DOI: 10.1016/0022-3913(94)90441-3.

7. Isidor F. Loss of osseointegration caused by occlusal load of oral implants. A clinical and radiographic study in monkeys. Clin Oral Implants Res. 1996; 7:143–52. DOI: 10.1034/j.1600-0501.1996.070208.x. PMID: 9002833.

8. Isidor F. Histologic evaluation of peri-implant bone at implants subjected to occlusal overload or plaque accumulation. Clin Oral Implants Res. 1997; 8:1–9. DOI: 10.1111/j.1600-0501.1997.tb00001.x. PMID: 9586450.

9. Jemt T, Book K. Prosthesis misfit and marginal bone loss in edentulous implant patients. Int J Oral Maxillofac Implants. 1996; 11:620–5. PMID: 8908860.

10. Naert I, Quirynen M, van Steenberghe D, Darius P. A study of 589 consecutive implants supporting complete fixed prostheses. Part II:prosthetic aspects. J Prosthet Dent. 1992; 68:949–56. DOI: 10.1016/0022-3913(92)90557-Q.

11. Adell R, Eriksson B, Lekholm U, Brånemark PI, Jemt T. Long-term followup study of osseointegrated implants in the treatment of totally edentulous jaws. Int J Oral Maxillofac Implants. 1990; 5:347–59. PMID: 2094653.

12. Tolman DE, Laney WR. Tissue-integrated prosthesis complications. Int J Oral Maxillofac Implants. 1992; 7:477–84. PMID: 1299643.

13. Rangert B, Krogh PH, Langer B, Van Roekel N. Bending overload and implant fracture:a retrospective clinical analysis. Int J Oral Maxillofac Implants. 1995; 10:326–34. PMID: 7615329.

14. Zarb GA, Schmitt A. The longitudinal clinical effectiveness of osseointegrated dental implants:the Toronto study. Part III:problems and complications encountered. J Prosthet Dent. 1990; 64:185–94. DOI: 10.1016/0022-3913(90)90177-E.

15. Walton JN, MacEntee MI. Problems with prostheses on implants:a retrospective study. J Prosthet Dent. 1994; 71:283–8. DOI: 10.1016/0022-3913(94)90468-5.

16. Worthington P, Bolender CL, Taylor TD. The Swedish system of osseointegrated implants:problems and complications encountered during a 4-year trial period. Int J Oral Maxillofac Implants. 1987; 2:77–84. PMID: 3325415.

17. Cox JF, Zarb GA. The longitudinal clinical efficacy of osseointegrated dental implants:a 3-year report. Int J Oral Maxillofac Implants. 1987; 2:91–100. PMID: 3325416.

18. Jemt T. Failures and complications in 391 consecutively inserted fixed prostheses supported by Brånemark implants in edentulous jaws:a study of treatment from the time of prosthesis placement to the first annual checkup. Int J Oral Maxillofac Implants. 1991; 6:270–6. PMID: 1813395.

19. Kallus T, Bessing C. Loose gold screws frequently occur in full-arch fixed prostheses supported by osseointegrated implants after 5 years. Int J Oral Maxillofac Implants. 1994; 9:169–78. PMID: 8206552.

20. Binon PP. Implants and components:entering the new millennium. Int J Oral Maxillofac Implants. 2000; 15:76–94. PMID: 10697942.

21. Brunski JB, Puleo DA, Nanci A. Biomaterials and biomechanics of oral and maxillofacial implants:current status and future developments. Int J Oral Maxillofac Implants. 2000; 15:15–46. PMID: 10697938.

22. Sones AD. Complications with osseointegrated implants. J Prosthet Dent. 1989; 62:581–585. DOI: 10.1016/0022-3913(89)90084-X.