Incidence and pattern of implant fractures: A long-term follow-up multicenter study

Currently, there is incomplete understanding of the fracture patterns in the implant and their association with clinical factors.

The aim of this study was to investigate the incidence and pattern of implant fracture (IF) by using 9-year, long-term multicenter follow-up data.

The association of the incidence and differences in fracture patterns with clinical factors (based on patient variables and implant variables) was assessed for statistical significance using the Chi-square and Fisher exact test, as appropriate.

Among a total of 19 087 implants in 8501 patients (7838 male and 663 female) placed over 9 years, fractures were observed in 70 implants (0.4%) in 57 patients (50 male and 7 female). Cases with less than 50% bone loss had a higher incidence of horizontal and vertical IFs limited to the crest module, which are defined as Type I fractures (n = 13, 18.6%). In contrast, cases with ≥50% severe bone loss exhibited a higher incidence of Type II vertical fractures (n = 22, 31.4%), extending beyond the crestal portion (P = .001). Type III fractures (n = 5, 7.1%), defined as a horizontal fracture beyond the crestal module, were also observed.

Peri-implantitis-induced marginal and vertical bone loss and manufacturing-induced defects were considered to be major factors in IF. Therefore, using clinically verified implant systems and striving to minimize bone loss by preventing and actively treating peri-implantitis is essential to reduce IFs.