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An Overview of the Mechanical Integrity of Dental Implants.

Shemtov-Yona K, Rittel D - Biomed Res Int (2015)

Bottom Line: Those complications are deemed severe in dentistry, albeit being usually considered as rare, and therefore seldom addressed in the clinical literature.The introduction of dental implants into clinical practice fostered a wealth of research on their biological aspects.The paper ends by a general discussion and suggestions for future research, outlining the importance of mechanical considerations for the improvement of their future performance.

View Article: PubMed Central - PubMed

Affiliation: Faculty of Mechanical Engineering, Technion, Israel Institute of Technology, 32000 Haifa, Israel.

ABSTRACT
With the growing use of dental implants, the incidence of implants' failures grows. Late treatment complications, after reaching full osseointegration and functionality, include mechanical failures, such as fracture of the implant and its components. Those complications are deemed severe in dentistry, albeit being usually considered as rare, and therefore seldom addressed in the clinical literature. The introduction of dental implants into clinical practice fostered a wealth of research on their biological aspects. By contrast, mechanical strength and reliability issues were seldom investigated in the open literature, so that most of the information to date remains essentially with the manufacturers. Over the years, implants have gone through major changes regarding the material, the design, and the surface characteristics aimed at improving osseointegration. Did those changes improve the implants' mechanical performance? This review article surveys the state-of-the-art literature about implants' mechanical reliability, identifying the known causes for fracture, while outlining the current knowledge-gaps. Recent results on various aspects of the mechanical integrity and failure of implants are presented and discussed next. The paper ends by a general discussion and suggestions for future research, outlining the importance of mechanical considerations for the improvement of their future performance.

No MeSH data available.


Related in: MedlinePlus

Embedded foreign particles on full cracks and crack-like defects, as identified on grit-blasted (with or without etching) implants. The white arrows mark the defects (full cracks or crack-like defects) and the white circles mark embedded foreign particles. Reprinted with permission from [49].
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fig7: Embedded foreign particles on full cracks and crack-like defects, as identified on grit-blasted (with or without etching) implants. The white arrows mark the defects (full cracks or crack-like defects) and the white circles mark embedded foreign particles. Reprinted with permission from [49].

Mentions: As a result, a standing issue is whether implanted structures are deteriorating without the knowledge of the practitioner until they break in a catastrophic manner. Shemtov-Yona and Rittel [49] addressed this issue for the first time and brought a preliminary answer to this question. Those authors interrogated systematically a cohort of 100 dental implants that were all extracted from the jawbone for biological reasons, while none of them was actually broken or even visibly damaged to the naked eye. Those implants were collected at random from 4 clinics, without any clinical or otherwise information on the patients, the implants, and their duration of service until extraction. Yet, by carefully scanning the overall surface of each and every implant, the following facts came to light. Over 60% of the scanned implants contained both defects that are analogous to microcracks and fully developed cracks. In addition, a high incidence of embedded particles was observed in close relation with the defects (Figure 7). This further strengthens the role played by the particles upon defects generation, some of which can later evolve into full cracks. One important outcome of that study was that, in those implants, the vast majority of cracks was associated with ceramic particles, indicating that no new cracks formed during service, so that future fracture, had it been allowed to develop, would have occurred from the preexisting cracks.


An Overview of the Mechanical Integrity of Dental Implants.

Shemtov-Yona K, Rittel D - Biomed Res Int (2015)

Embedded foreign particles on full cracks and crack-like defects, as identified on grit-blasted (with or without etching) implants. The white arrows mark the defects (full cracks or crack-like defects) and the white circles mark embedded foreign particles. Reprinted with permission from [49].
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4637045&req=5

fig7: Embedded foreign particles on full cracks and crack-like defects, as identified on grit-blasted (with or without etching) implants. The white arrows mark the defects (full cracks or crack-like defects) and the white circles mark embedded foreign particles. Reprinted with permission from [49].
Mentions: As a result, a standing issue is whether implanted structures are deteriorating without the knowledge of the practitioner until they break in a catastrophic manner. Shemtov-Yona and Rittel [49] addressed this issue for the first time and brought a preliminary answer to this question. Those authors interrogated systematically a cohort of 100 dental implants that were all extracted from the jawbone for biological reasons, while none of them was actually broken or even visibly damaged to the naked eye. Those implants were collected at random from 4 clinics, without any clinical or otherwise information on the patients, the implants, and their duration of service until extraction. Yet, by carefully scanning the overall surface of each and every implant, the following facts came to light. Over 60% of the scanned implants contained both defects that are analogous to microcracks and fully developed cracks. In addition, a high incidence of embedded particles was observed in close relation with the defects (Figure 7). This further strengthens the role played by the particles upon defects generation, some of which can later evolve into full cracks. One important outcome of that study was that, in those implants, the vast majority of cracks was associated with ceramic particles, indicating that no new cracks formed during service, so that future fracture, had it been allowed to develop, would have occurred from the preexisting cracks.

Bottom Line: Those complications are deemed severe in dentistry, albeit being usually considered as rare, and therefore seldom addressed in the clinical literature.The introduction of dental implants into clinical practice fostered a wealth of research on their biological aspects.The paper ends by a general discussion and suggestions for future research, outlining the importance of mechanical considerations for the improvement of their future performance.

View Article: PubMed Central - PubMed

Affiliation: Faculty of Mechanical Engineering, Technion, Israel Institute of Technology, 32000 Haifa, Israel.

ABSTRACT
With the growing use of dental implants, the incidence of implants' failures grows. Late treatment complications, after reaching full osseointegration and functionality, include mechanical failures, such as fracture of the implant and its components. Those complications are deemed severe in dentistry, albeit being usually considered as rare, and therefore seldom addressed in the clinical literature. The introduction of dental implants into clinical practice fostered a wealth of research on their biological aspects. By contrast, mechanical strength and reliability issues were seldom investigated in the open literature, so that most of the information to date remains essentially with the manufacturers. Over the years, implants have gone through major changes regarding the material, the design, and the surface characteristics aimed at improving osseointegration. Did those changes improve the implants' mechanical performance? This review article surveys the state-of-the-art literature about implants' mechanical reliability, identifying the known causes for fracture, while outlining the current knowledge-gaps. Recent results on various aspects of the mechanical integrity and failure of implants are presented and discussed next. The paper ends by a general discussion and suggestions for future research, outlining the importance of mechanical considerations for the improvement of their future performance.

No MeSH data available.


Related in: MedlinePlus