Evaluation of Success of Implant- Supported Prostheses with Two Different Implant-Abutment Connections: A Retrospective Study

Öz

Objectives: This retrospective clinical study evaluated the complications and failures of dental implants (NTA, Toros Dental, Turkey) with two different implant-abutment connection types, screwless conical locking-taper and conventional screw connection, for two years.
Material and Method: A total of 126 implant-supported restorations constructed after osseointegration of 290 dental implants applied to 75 patients in 2018-2020 were evaluated. Patients were recalled at six-month intervals, and clinical evaluations and complications were recorded. Types of prosthetic restoration applied; prosthetic restoration material types as single crown, fixed partial denture and overdenture prostheses; metal-ceramic restorations, zirconium-ceramic restorations and metal-acrylic resin restorations.
Results: As a result of the clinical evaluations among different implant abutment connections; complications of prosthetic restorations applied to implants with screwless conical locking-taper connection; loss of retention in fixed restorations (4, 5.6%), loss of retention in retainers of overdenture prostheses (2, 2.8%), and veneer ceramic fractures (6, 8.5%). Complications of prosthetic restorations applied to implants with conventional screw connection; loss of retention in fixed restorations (10, 8.2%), loss of retention in retainers of overdenture prostheses (2, 3.6%), veneer ceramic fractures (5, 9.1%), infrastructure fracture (1, 1%, 8), acrylic resin base fractures (2, 3.6%). The failure rate of screw-connected implant-supported restorations was 36.3%, and the failure rate of screwless conical locking tapered implant-supported restorations was 16.9%.
Conclusions: When the complication or failure rates of prosthetic restorations were evaluated; It was seen that screwless conical locking tapered implant-supported restorations were more successful than screw-connected implant-supported restorations.

Anahtar Kelimeler

• : Implant-supported prostheses
• screwless locking taper
• implant-abutment connection

İki Farklı İmplant-Dayanak Bağlantısına Sahip İmplantüstü Protezlerin Başarısının Değerlendirilmesi: Retrospektif Çalışma

Öz

Amaç: Bu çalışma konik kilitli ve vidalı bağlantılı olmak üzere iki farklı implant-dayanak bağlantı tipine sahip dental implantların desteklediği (NTA, Toros Dental, Türkiye) implantüstü restorasyonlarda meydana gelen komplikasyon ve başarısızlıkların geriye dönük iki yıllık değerlendirilmesini amaçladı.
Materyal-Metot: 2018-2020 yıllarında, toplam 75 hastaya uygulanan 290 adet dental implantın osseointegrasyon sonrası yapılan toplam 126 implantüstü restorasyon çalışmaya dahil edildi. Hastalar altı aylık aralıklarla kontrole çağırılarak klinik değerlendirmeler ile restorasyonlarda meydana gelen komplikasyonlar kaydedildi. Uygulanan protetik restorasyon tipleri; tek kron, sabit bölümlü köprü ve overdenture protezler olarak, protetik restorasyon materyal tipleri ise; metal seramik restorasyonlar, zirkonyum destekli seramik restorasyonlar ve metal akrilik rezin restorasyonlar olarak kaydedildi.
Bulgular: Farklı implant abutment bağlantısına sahip implantlar ile restore edilen 75 hastada yapılan klinik değerlendirmeler sonucu; konik kilitli bağlantılı implant üstü protetik restorasyonlarda meydana gelen komplikasyonlar; sabit restorasyonlarda meydana gelen retansiyon kaybı (4, %5,6), overdenture protezlerin tutucularında oluşan retansiyon kaybı (2, %2,8), veneer seramiği kırığı (6, %8,5) olarak belirlendi. Vida bağlantılı implant üstü protetik restorasyonlarda meydana gelen komplikasyonlar; sabit restorasyonlarda meydana gelen retansiyon kaybı (10, %8,2), overdenture protezlerin tutucularında oluşan retansiyon kaybı (2, %3,6), veneer seramiği kırığı (5, %9,1), altyapı kırığı (1, %1,8), akrilik kaide kırığı (2, %3,6) olarak belirlendi. Vida bağlantılı implant üstü protetik restorasyonlarda görülen başarısızlık oranı %36,3, konik kilitli bağlantılı implant üstü protetik restorasyonlarda görülen başarısızlık oranı %16,9 olarak tespit edildi.
Sonuç: İmplant üstü protetik restorasyonların komplikasyon veya başarısızlık oranları değerlendirildiğinde; konik kilitli bağlantılı implant üstü protetik restorasyonların vida bağlantılı implant üstü protetik restorasyonlardan daha başarılı olduğu görüldü.

Anahtar Kelimeler

• : İmplantüstü protezler
• konik kilitli
• implant-abutment bağlantı
• protetik komplikasyonlar

Kaynakça

1. [1] Moraschini V, Poubel LA, Ferreira VF, Barboza Edos S. Evaluation of survival and success rates of dental implants reported in longitudinal studies with a follow-up period of at least 10 years: a systematic review. Int J Oral Maxillofac Surg. 2015;44(3):377-388.
2. [2] Blanes RJ, Bernard JP, Blanes ZM, Belser UC. A 10-year prospective study of ITI dental implants placed in the posterior region. II: Influence of the crown-to-implant ratio and different prosthetic treatment modalities on crestal bone loss. Clin Oral Implants Res. 2007;18(6):707-714.
3. [[3] Real-Osuna J, Almendros-Marqués N, Gay-Escoda C. Prevalence of complications after the oral rehabilitation with implant-supported hybrid prostheses. Med Oral Patol Oral Cir Bucal. 2012;17(1):e116-e121.
4. [4] Göthberg C, Bergendal T, Magnusson T. Complications after treatment with implant-supported fixed prostheses: a retrospective study. Int J Prosthodont. 2003;16(2):201-207.
5. [5] Hemmings KW, Schmitt A, Zarb GA. Complications and maintenance requirements for fixed prostheses and overdentures in the edentulous mandible: a 5-year report. Int J Oral Maxillofac Implants. 1994;9(2):191-196.
6. [6] Ricomini Filho AP, Fernandes FS, Straioto FG, da Silva WJ, Del Bel Cury AA. Preload loss and bacterial penetration on different implant-abutment connection systems. Braz Dent J. 2010;21(2):123-129.
7. [7] Pita MS, Anchieta RB, Barão VA, Garcia IR Jr, Pedrazzi V, Assunção WG. Prosthetic platforms in implant dentistry. J Craniofac Surg. 2011;22(6):2327-2331.
8. [8] Alsaadi G, Quirynen M, Michiles K, Teughels W, Komárek A, van Steenberghe D. Impact of local and systemic factors on the incidence of failures up to abutment connection with modified surface oral implants. J Clin Periodontol. 2008;35(1):51-57.

9. [9] Blanes RJ. To what extent does the crown-implant ratio affect the survival and complications of implant-supported reconstructions? A systematic review. Clin Oral Implants Res. 2009;20 Suppl 4:67-72..
10. [10] Geng JP, Tan KB, Liu GR. Application of finite element analysis in implant dentistry: a review of the literature. J Prosthet Dent. 2001;85(6):585-598.
11. [11] Bozkaya D, Müftü S. Mechanics of the taper integrated screwed-in (TIS) abutments used in dental implants. J Biomech. 2005;38(1):87-97.
12. [12] Merz BR, Hunenbart S, Belser UC. Mechanics of the implant-abutment connection: an 8-degree taper compared to a butt joint connection. Int J Oral Maxillofac Implants. 2000;15(4):519-526.
13. [13] Chapman RJ, Grippo W. The locking taper attachment for implant abutments: use and reliability. Implant Dent. 1996;5(4):257-261.
14. [14] Schmitt CM, Nogueira-Filho G, Tenenbaum HC, et al. Performance of conical abutment (Morse Taper) connection implants: a systematic review. J Biomed Mater Res A. 2014;102(2):552-574.
15. [15] Jansen VK, Conrads G, Richter EJ. Microbial leakage and marginal fit of the implant-abutment interface [published correction appears in Int J Oral Maxillofac Implants 1997 Sep-Oct;12(5):709]. Int J Oral Maxillofac Implants. 1997;12(4):527-540.
16. [16] Hansson S. A conical implant-abutment interface at the level of the marginal bone improves the distribution of stresses in the supporting bone. An axisymmetric finite element analysis. Clin Oral Implants Res. 2003;14(3):286-293.
17. [17] Romanos GE, Nentwig GH. Single molar replacement with a progressive thread design implant system: a retrospective clinical report. Int J Oral Maxillofac Implants. 2000;15(6):831-836.
18. [18] Mangano C, Bartolucci EG. Single tooth replacement by Morse taper connection implants: a retrospective study of 80 implants. Int J Oral Maxillofac Implants. 2001;16(5):675-680.
19. [19] Döring K, Eisenmann E, Stiller M. Functional and esthetic considerations for single-tooth Ankylos implant-crowns: 8 years of clinical performance. J Oral Implantol. 2004;30(3):198-209.
20. [20] Goodacre BJ, Goodacre SE, Goodacre CJ. Prosthetic complications with implant prostheses (2001-2017). Eur J Oral Implantol. 2018;11 Suppl 1:S27-S36.
21. [21] Mangano F, Macchi A, Caprioglio A, Sammons RL, Piattelli A, Mangano C. Survival and complication rates of fixed restorations supported by locking-taper implants: a prospective study with 1 to 10 years of follow-up. J Prosthodont. 2014;23(6):434-444.
22. [22] McDermott NE, Chuang SK, Woo VV, Dodson TB. Complications of dental implants: identification, frequency, and associated risk factors. Int J Oral Maxillofac Implants. 2003;18(6):848-855.
23. [23] Cehreli MC, Karasoy D, Kökat AM, Akça K, Eckert S. A systematic review of marginal bone loss around implants retaining or supporting overdentures. Int J Oral Maxillofac Implants. 2010;25(2):266-277.
24. [24] Mangano C, Mangano F, Piattelli A, Iezzi G, Mangano A, La Colla L. Prospective clinical evaluation of 1920 Morse taper connection implants: results after 4 years of functional loading. Clin Oral Implants Res. 2009;20(3):254-261.
25. [25] Mangano C, Mangano F, Shibli JA, Ricci M, Sammons RL, Figliuzzi M. Morse taper connection implants supporting "planned" maxillary and mandibular bar-retained overdentures: a 5-year prospective multicenter study. Clin Oral Implants Res. 2011;22(10):1117-1124.
26. [26] Hanif A, Qureshi S, Sheikh Z, Rashid H. Complications in implant dentistry. Eur J Dent. 2017;11(1):135-140.
27. [27] Urdaneta RA, Marincola M, Weed M, Chuang SK. A screwless and cementless technique for the restoration of single-tooth implants: a retrospective cohort study. J Prosthodont. 2008;17(7):562-571.
28. [28] Mangano C, Mangano F, Shibli JA, et al. Prospective evaluation of 2,549 Morse taper connection implants: 1- to 6-year data. J Periodontol. 2011;82(1):52-61.
29. [29] Sahin S, Cehreli MC, Yalçin E. The influence of functional forces on the biomechanics of implant-supported prostheses--a review. J Dent. 2002;30(7-8):271-282.
30. [30] Gonda T, Maeda Y, Walton JN, MacEntee MI. Fracture incidence in mandibular overdentures retained by one or two implants. J Prosthet Dent. 2010;103(3):178-181.
31. [31] Vere J, Bhakta S, Patel R. Implant-retained overdentures: a review. Dent Update. 2012;39(5):370-375.
32. [32] Fajardo RS, Pruitt LA, Finzen FC, Marshall GW, Singh S, Curtis DA. The effect of E-glass fibers and acrylic resin thickness on fracture load in a simulated implant-supported overdenture prosthesis [published correction appears in J Prosthet Dent. 2012 Feb;107(2):101. Singh, Sukhmony [corrected to Singh, Sukhmani]]. J Prosthet Dent. 2011;106(6):373-377.
33. [33] Öztürk G, Dündar Çömlekoğlu M, Çömlekoğlu E, Sonugelen M. Effect of retentive attachments on clinical success of implant overdenture: A review. EÜ Dişhek Fak Derg. 2013;34(1):11-6.