Risk factors for abutment and implant fracture after loading

Implant component fractures are one of the most serious complications in implant treatment. With a better understanding of the risk factors for fracture in the preoperative, surgery, superstructure, and post-loading phases of implant treatment, low-risk treatment could reduce implant component fractures, leading to a better prognosis. The aim of this study was to clarify the risk factors for abutment and implant fractures that occur after loading, and to perform a retrospective, approximately 10-year follow-up study to explore the risk factors in each treatment phase.

Subjects were fitted with an implant prosthesis between January 2008 and December 2009. In total, 1,126 Ankylos implants in 430 patients were included for analysis. Binary logistic regression analysis was performed to extract factors related to non-fracture and fracture of the abutment or implant as a dependent variable.

Gender (OR = 3.466, 95% CI 1.296-9.268, P = 0.013), gonial angle (OR = 3.420, 95% CI 1.308-8.945, P = 0.012), and splinting status of the superstructure (OR = 4.456, 95% CI 1.861-10.669, P = 0.001) were identified as significant risk factors.

The risk of fracture is increased in males, especially those with a mandibular angle of less than 120° on panoramic radiographs, and those with a non-splinted superstructure.