Retrospective Radiographic Evaluation of Implant Complications: CBCT-Based Study

Year 2024, Issue: 3, 9 - 17, 15.10.2024

Didem Dumanlı , Çiğdem Şeker , Gediz Geduk

https://doi.org/10.51122/neudentj.2024.110

Abstract

Aim: Dental implants are a popular treatment option for patients with one or more missing teeth. With the increase in dental implant treatments, the complications encountered have increased. Therefore, it is very important to plan the implant by evaluating the anatomy of the area where the implant will be placed in three dimensions with cone beam computed tomography (CBCT). The aim of this study is to evaluate the prevalence of implant complications seen in CBCT after implant applications.
Material and Methods: CBCT images of 500 patients obtained for different dental reasons were examined; among these, 300 dental implant images were evaluated retrospectively in terms of complications. The number, location and type of identified complications (perforation in the maxillary sinus, mandibular canal, cortical bone, nasal cavity, and mental canal; contact with the adjacent tooth root) were recorded. The data obtained were analyzed statistically using chi-square tests.
Results: At least one complication was detected in 65% of the 300 dental implants evaluated. A total of 272 complications (1,4 complications per implant) were observed in 195 dental implants with complications. The number of implants with complications per patient was found to be 3,9. The most observed complication was found to be vertical bone resorption around the implant (45%). Complications were most frequently detected in the maxillary posterior region (40%).
Conclusion: Three-dimensional CBCT evaluation of the area where the implant will be applied before and after treatment is very important to prevent possible complications.

Keywords

implant, complication, cortical bone, maxillary sinus

İmplant Komplikasyonlarının Retrospektif Olarak Radyografik Değerlendirilmesi: KIBT Tabanlı Çalışma

Abstract

Amaç: Dental implantlar, bir veya daha fazla diş eksikliği olan hastalar için popüler bir tedavi seçeneğidir. Dental implant tedavilerinin artmasıyla birlikte karşılaşılan komplikasyonlarda artmıştır. Bu yüzden implantın yerleştirileceği bölgenin anatomisini üç boyutlu olarak konik ışınlı bilgisayarlı tomografi (KIBT) ile değerlendirerek implant planlaması yapmak çok önemlidir. Bu çalışmanın amacı, implant uygulamaları sonrası KIBT’da görülen implant komplikasyonlarının prevalansının değerlendirilmesidir.
Gereç ve Yöntemler: Farklı dental nedenlerden dolayı elde edilmiş 500 hastaya ait KIBT görüntüleri incelendi; bunların içinden 300 dental implant tespit edilen görüntüler komplikasyonlar açısından retrospektif olarak değerlendirildi. Belirlenen komplikasyonların sayısı, lokalizasyonu ve tipi (maksiller sinüs, mandibular kanal, kortikal kemik, nazal kavite, ve mental kanalda perforasyon; komşu diş kökü ile temas) kaydedildi. Elde edilen veriler ki-kare testleriyle istatistiksel olarak analiz edildi.
Bulgular: Değerlendirilen 300 dental implantın % 65’inde en az bir komplikasyon tespit edildi. Komplikasyonlu 195 dental implantta toplam 272 komplikasyon (implant başına 1,4 komplikasyon) gözlendi. Hasta başına düşen komplikasyonlu implant sayısı 3,9 olarak bulundu. En fazla gözlenen komplikasyon implant çevresindeki vertikal kemik rezorpsiyonu (%45) olarak bulundu . En sık maksiller posterior bölgede (%40) komplikasyon tespit edildi.
Sonuç: İmplantın uygulanacağı bölgenin KIBT ile üç boyutlu olarak tedavi öncesi ve sonrası değerlendirilmesi meydana gelebilecek komplikasyonların önlenmesi açısından çok önemlidir.

Keywords

implant, komplikasyon, kortikal kemik, maksiller sinüs

References

• Balshi TJ, Wolfinger GJ, Stein BE, Balshi SF. A long- term retrospective analysis of survival rates of implants in the mandible. Int J Oral Maxillofac Implants. 2015;30:1348-54.
• DeAngelis F, Papi P, Mencio F, Rosella D, DiCarlo S, Pompa G. Implant survival and success rates in patients with risk factors: results from a long-term retrospective study with a 10 to 18 years follow-up. Eur Rev Med Pharmacol Sci. 2017;21:433-7.
• Pamukcu U, Ispir GN, Alkurt MT, Altunkaynak B, Peker İ. Retrospective evaluation of complications in dental implants using cone beam computed tomography. Selcuk Dent J. 2021;8:367-371.
• Kohavi D, Azran G, Shapiral C, Casap N. Retrospective clinical review of dental implants placed in a university training program. J Oral Implantol. 2004;30:23-9.
• Clark D, Barbu H, Lorean A, Mijiritsky E, Levin L. Incidental findings of implant complications on postimplantation cbcts: a cross‐sectional study. Clin İmplant Dent Relat Res. 2017;19:776-782.
• Misch K, Wang H-L. Implant surgery complications: etiology and treatment. Implant Dent. 2008;17:159-68.
• Urvasızoglu G, Turen T. Prevalence and treatment methods of intraoperative and early complications encountered in dental implant applications: a retrospective clinical study. Curr Res Dent Sci. 2019;29:259-67.
• Park SH, Wang HL. Implant reversible complications: classification and treatments. Implant Dent. 2005;14:211-20.
• Elhamruni LM, Marzook HA, Ahmed WM, Abdul-Rahman M. Experimental study on penetration of dental implants into the maxillary sinus at different depths. Oral Maxillofac Surg. 2016;20:281–87.
• White S, Pharoah’s M. Oral Radiology Principles and Interpretation. 8th ed. St. Louis: Mosby; 2018. p. 325-515.
• Froum S. Implant complications: scope of the problem. In Froum S. Dental implant complications. New York: John Wiley & Sons; 2010. p. 2-6.
• Quirynen M, Abarca M, Assche VN, Nevins M, Steenberghe DV. Impact of supportive periodontal therapy and implant surface roughness on implant outcome in patients with a history of periodontitis. J Clin Periodontol. 2007;34:805-15.
• Moy PK, Medina D, Shetty V, Aghaloo TL. Dental implant failurerates and associated risk factors. Int J Oral Maxillofac Implants. 2005;20:569-77.
• Palma-Carrió C, Maestre-Ferrín L, Peñarrocha-Oltra D, Peñarrocha-Diago MA, Peñarrocha-Diago M Risk factors associated with early failure of dental implants. A literature review Med Oral Patol Oral Cir Bucal. 2011;16:514-7.
• Balshi TJ, Wolfinger GJ. Dental implants in the diabetic patient: A retrospective study. Implant Dent. 1999;8:355-9.
• Javed F, Romanos GE. Review impact of diabetes mellitus and glycemic control on the osseointegration of dental ımplants: A Systematic Literature Review. J Periodontol. 2009; 80:1719-30.
• Zetu L, Wang HL. Management of inter- dental/inter-implant papilla. J Clin Periodontol. 2005;32:831–9.
• Kim SG. Implant-related damage to an adjacent tooth: a case report. Implant Dent. 2000;9:278-80.
• Balaguer-Marti JC, Penarrocha-Oltra D, Balaguer-Martinez J, Penar- rocha-Diago M. Immediate bleeding complications in dental implants: a systematic review. Med Oral Patol Oral Cir Bucal. 2015;20:e231-8.
• Felisati G, Lozza P, Chiapasco M, Borloni R. Endoscopic removal of an unusual foreign body in the sphenoid sinus: an oral implant. Clin Oral Implants Res. 2007:18;776-80.
• Ozmarasali AI, Kaplan DA, Eser P, Yilmazlar S. Dental implant misplacement into the anterior cranial fossae: a unique case and review of literature. Neurochirurgie. 2024;70:101533.
• Al-Sabbagh M, Okeson JP, Khalaf MW, Bhavsar I. Persistent pain and neurosensory disturbance after dental implant surgery: pathophysiology, etiology, and diagnosis. Dent Clin North Am. 2015;59:131-42.
• Politis C, Agbaje J, Van Hevele J, Nicolielo L, De Laat A, Lambrichts I, et al. Report of neuropathic pain after dental ımplant placement: a case series. . Int J Oral Maxillofac Implants. 2017;32:439-44.
• Ribas BR, Nascimento HL, Freitas DQ, dos Anjos PA, dos Anjos ML, Perez DEC, et al. Positioning errors of dental implants and their associations with adjacent structures and anatomical variations: a CBCT-based study. Imaging Sci Dent. 2020;50:281-90.
• Juodzbalys G, Wang HL, Sabalys G. Injury of the inferior alveolar nerve during implant placement: a literature review. J Oral Maxillofac Res. 2011;2:e1.
• Peterson LJ, Ellı̇s E, Hupp JR, Tucker MR. Contemporary Oral and Maxillofacial Surgery. 4th ed. St. Louis: Mosby; 2003. p. 310-313.
• Wolff J, Karagozoglu KH, Bretschneider JH, Forouzanfar T, Schulten EA. Altered nasal airflow: an unusual complication following implant surgery in the anterior maxilla. Int J Implant Dent. 2016;2:6.
• Greensteı̇n G, Cavallaro J, Romanos G, Tarnow D. Clinical recommendations for avoiding and managing surgical complications associated with implant dentistry: a review. J Periodontol. 2008;79:1317-29.
• Seghers D., Berkus T, Oelhafen M, Munro P, Star-Lack J. Comparison of state of the art interpolation‐based metal artifact reduction (MAR) algorithms for cone beam computed tomography (CBCT). Med Phys. 2012;39:3628.
• Mancini AX, Santos MU, Gaêta-Araujo H, Tirapelli C, Pauwels R., Oliveira-Santos C. Artefacts at different distances from titanium and zirconia implants in cone-beam computed tomography: effect of tube current and metal artefact reduction. Clin Oral Investig. 2021;25:5087-94.
• González-Martín O, Oteo C, Ortega R, Alandez J, Sanz M, Veltri M. Evaluation of peri-implant buccal bone by computed tomography: an experimental study. Clin Oral Implants Res. 2016;27:950-5.
• Fienitz T, Schwarz F, Ritter L, Dreiseidler T, Becker J, Rothamel D. Accuracy of cone beam computed tomography in assessing peri-implant bone defect regeneration: a histologically controlled study in dogs. Clin Oral Implants Res. 2012;23:882-7.
• Hilgenfeld T, Juerchott A, Deisenhofer UK, Krisam J, Rammelsberg P, Heiland S, et al. Accuracy of cone-beam computed tomography, dental magnetic resonance imaging, and intraoral radiography for detecting peri-implant bone defects at single zirconia implants an in vitro study. Clin Oral Implants Res. 2018;29:922-30.