Treating fractured implants

The purpose of this article is to outline an achievable treatment solution to a problem we may increasingly see with older restored dental implants which have experienced a tough tour of duty.

Biomechanical complications of implant treatment include marginal bone loss, prosthodontic material fractures, loosening or fracturing of abutment screws and, uncommonly, implant failure. The incidence of dental implant fracture is reported to be between 0.16–1.5 per cent for restored cases over varying periods. In the aetiology of implant fracture, many studies confirm occlusal overloading, para functional habits and bruxism to be the identifiable clinical factors. In simple terms, mechanical overload from whatever cause must be ultimately responsible for the failure. This area of research is inherently difficult to firstly understand (quantify) the loading cycles placed on the successfully integrated and restored implants and secondly, to determine the relevant mechanical, biological and restorative factors contributing to the overall restorative failure. It is a serious concern that recent estimates for Implant-supported Fixed Complete Dental Prosthesis (IFCDPs) ‘free of complication’ could be as low as 8.6 per cent over 10 years and technical failure complications (largely mechanical screw fracture) over the same period is 20.8 per cent. Selection of the most suitable dental implant, both for the clinical outcome and the long term mechanical/biological stability remains with the dental surgeon.