A 5-Year Retrospective Analysis of Biologic and Prosthetic Complications Associated With Single-Tooth Endosseous Dental Implants: Practical Applications

Abstract

Focused clinical question: What are the key considerations of the incidence and timing for single-tooth implant complications, including early failure, biological complications, and prosthetic complications?

Summary: Single-tooth dental implants have been shown to have a high overall survival rate, but implant complications affect patient satisfaction and may lead to costly and/or time-consuming repair and revision. Assessing the incidence and types of biologic and prosthetic complications and the timing of such complications is helpful so that the underlying causes can be addressed during the treatment planning process. Furthermore, identification of patient demographics, patient-, implant-, and site-specific factors associated with such complications may allow for more comprehensive risk assessment during treatment planning.

Conclusions: Overall, dental implants have a high survival rate. Identification of the incidence of both biologic and prosthetic complications and minimizing their impact in patients with dental implants is critical to overall implant success. Utilization of careful treatment planning and dental implant fixtures, surgical protocols, and prosthetic designs that reduce complication rates can improve patient acceptance and outcomes. Further research is necessary to fully assess complication rates and risk factors.

Keywords: Alveolar Bone Loss/Therapy; Dental Implantation/Endosseous; Dental Prosthesis/Adverse Events; Peri-Implantitis; Periodontal Diseases.

FIGURE 1

A-F, Early implant failure at site #9 with immediate implant failure. 1a,1b, Postoperative clinical photograph and radiograph after immediate implant placement and custom abutment placement at site #9. 1c,1d, Clinical photograph and radiograph 2 weeks after placement when patient presented with pain and mobility at the implant site. 1e,1f, Clinical photographs of the explantation site and explanted implant after early implant failure and implant removal

FIGURE 2

A-F, Late biologic implant failure at site #19. 2a, Postoperative radiograph after implant placement at sites #18–20. 2b, Post-temporization radiograph at implants #18–20, 4 months after implant placement. 2c,2d, Clinical photograph and radiograph 2 years after implant placement when patient presented with mobility at implant #19. 2e,2f, Radiograph and clinical photograph of explantation site and explanted implant after loss due to peri-implantitis

FIGURE 3

A-H, Late prosthetic implant failure at site #19. 3a,3b, Radiographs prior to and at the time of dental implant placement at #19. 3c, Implant restoration placed 3 months after surgical implant placement. 3d, Implant at 1 year post-restoration demonstrating 1–2mm of radiographic crestal bone loss. 3e, Implant at 2 years post-restoration after loss of implant supported abutment and crown due to abutment screw fracture. 3f, Restoration with fractured abutment screw. 3g, Intrasurgical intrabony peri-implant defect dimensions. 3h, 8 months postsurgical grafting procedure with placement of new implant-supported abutment and screw-retained crown

FIGURE 4

A-D, Implant health at implant #30 at 5 years after placement. 4a, Post-operative radiograph at time of implant placement site #30. 4b, Radiograph at implant #30 after final restoration placement. 4c,4d, Clinical photograph and radiograph 5 years after implant placement at site #30 demonstrating maintenance of bone levels and a lack of clinical signs and symptoms of inflammation