Implant fracture failure rate and potential associated risk indicators: An up to 12-year retrospective study of implants in 5,124 patients.

Abstract

This study investigated fracture rates and risk indicators for fractures in internal connection dental implants. We performed a retrospective analysis of 19,006 internal connection implants used in fixed restoration in 5,124 patients (4,570 males, 554 females) at the Dental Hospital of Veterans Health Service Medical Center between 2006 and 2015. Patients were followed through June 2018 (0.03-12.39years post-installation). Clinical factors (age, sex, implant diameter, implant length, placement site, bone graft, fixture material, cervical feature, abutment connection, microthread, and platform switching) were recorded. Kaplan-Meier survival analysis identified risk indicators associated with an implant fracture. Cox regression models elucidated potential fracture risks. One hundred and seventy-four implants fractured in 135 patients, for an incidence rate of 0.92% after an average of 4.95±2.14years of use. Kaplan-Meier estimates showed that the 3-, 5-, and 10-year survival rates of implants were 99.8%, 99.2%, and 97.7%, respectively. In the multivariable Cox regression model, the diameter, location, history of bone graft, and microthread presence were significantly correlated with implant fractures. Wide-diameter implants had a reduced fracture risk within 90months, after which the diameter did not correlate with fractures. Implants placed in the anterior mandible had a lower fracture risk within 90months; mandibular premolar implants corresponded with a lower risk after 90months. Implants without a history of bone graft or microthreads were more likely to fracture throughout the follow-up time. These results elucidate risk indicators for implant fractures and facilitate their reduction in clinical practice.