Potential risk factors for implant failure in temporomandibular disorders patients

Aim: The aim of this study was to evaluate the effects of abnormal occlusal forces on dental implants in patients with temporomandibular disorders (TMD), and to focus on concepts and the clinical procedures to reduce the potential risk factors for implant failure. The heavy force of compression, clenching and grinding, as in bruxism, simultaneously applies strong pressures to the implants, crestal bone, restorations and temporomandibular joints. This is a potential risk factor for crestal bone loss, loss of integration before and after restoration, abutment screw loosening and fracture, implant fracture, decementation of restorations and fracture of the porcelain. Materials and methods: 28 TMD patients were compared to 28 no-TMD patients in which were inserted 267 implants with the same features as number, size, position, design. Besides, were considered type of restoration, cemented or screwed, malocclusion type, smoking, load timing. Results: The results show that increasing the number of implants and reducing cantilevers, the stress on each one decreases; using the longest and widest implant possible increases implant-bone surface area and reduces also strain on the restorations. Also implant design, occlusal table width, direction, duration and magnification of the forces influences the stress at the crestal bone-implant surface. Anterior guidance during excursive movements reduces forces and eliminate all lateral occlusal contact. Conclusion: Patients with temporomandibular disorders and bruxism can be eligible for implants, provide that treatment plans controlling the chronic bruxism through night-guards and modifying the occlusal forces on implants and their restorations are developed

Implant overloading and parafunctions : avoiding and managing complications

Aim: The aim of this study was to show the destructive effects of abnormal occlusal forces on implant supported prostheses in patients with bruxism, abnormal habits and other parafunctions, and to focus on concepts and the clinical procedures to reduce the potential risk factors for implant failure. Material and Methods: Forty TMD patients were compared to 40 no-TMD patients in which were inserted 430 implants with the same features as number, size, position, design. Another experimental group of 50 TMD patients treated by prevention protocol was assessed. Were considered type of restoration, cemented or screwed, malocclusion type, smoking, load timing. The heavy force of compression, clenching and grinding, as in bruxism, simultaneously applied strong pressures to the implants, crestal bone, restorations and temporomandibular joints. This was a potential risk factor for crestal bone loss, loss of integration before and after restoration, abutment screw loosening and fracture, implant fracture, decementation of restorations and fracture of the porcelain. Results: The 5 years follow-up showed a 58% of soft tissues, bone and prosthetic complications in TMD patients versus a 11% in non TMD patients (P< 0.01). When TMD patients were undergone to occlusal overload prevention protocol, the complications were diminished to 13% (P< 0.01). Conclusion: Implants with platform switching could avoid complications and enhance osseointegration success rate. Developing treatment plan that control the chronic bruxism through night-guards and an occlusal adjustment protocol to modify the occlusal forces on implants and their restorations, patients with temporomandibular disorders and bruxism can be candidates for implants

Implant overloading and parafunctions : avoiding and managing complications

Aim: The aim of this study was to show the destructive effects of abnormal occlusal forces on implant supported prostheses in patients with bruxism, abnormal habits and other parafunctions, and to focus on concepts and the clinical procedures to reduce the potential risk factors for implant failure. Material and Methods: 40 TMD patients were compared to 40 no-TMD patients in which were inserted 430 implants with the same features as number, size, position, design. Another experimental group of 50 TMD patients treated by prevention protocol was assessed. Besides, were considered type of restoration, cemented or screwed, malocclusion type, smoking, load timing. The heavy force of compression, clenching and grinding, as in bruxism, simultaneously applied strong pressures to the implants, crestal bone, restorations and temporomandibular joints. This was a potential risk factor for crestal bone loss, loss of integration before and after restoration, abutment screw loosening and fracture, implant fracture, decementation of restorations and fracture of the porcelain. Results: The 5 years follow-up showed a 58% of soft tissues, bone and prosthetic complications in TMD patients versus a 11% in non TMD patients (P< 0.01). When TMD patients were undergone to occlusal overload prevention protocol, the complications were diminished to 13% (P< 0.01). Increasing the number of implants and reducing cantilevers decreases the stress; using the longest and widest implant possible increases implant/bone surface area and reduces also strain. Also implant design, occlusal table size, the direction, duration and magnification of the forces influences the stress at the crestal bone/implant surface. Anterior guidance during excursive movements reduces forces and eliminate all lateral occlusal contact. Conclusion: Developing treatment plan that control the chronic bruxism through night-guards and an occlusal adjustment protocol to modify the occlusal forces on implants and their restorations, patients with temporomandibular disorders and bruxism can be candidates for implants

Potential risk factors of prosthetic implant failure: occlusal overload prevention

Aim: The aim of this study was to evaluate the effects of abnormal occlusal forces on dental implants in patients with temporomandibular disorders (TMD), and to focus on concepts and the clinical procedures to reduce the potential risk factors for implant failure. Material and Methods: Twenty-eight TMD patients were compared to 28 no-TMD patients in which were inserted 267 implants with the same features as number, size, position, design. Another experimental group of 30 TMD patients treated by prevention protocol was assessed. Besides, were considered type of restoration, cemented or screwed, malocclusion type, smoking, load timing. The heavy force of compression, clenching and grinding, as in bruxism, simultaneously applied strong pressures to the implants, crestal bone, restorations and temporomandibular joints. This was a potential risk factor for crestal bone loss, loss of integration before and after restoration, abutment screw loosening and fracture, implant fracture, decementation of restorations and fracture of the porcelain. Results: The 5 years follow-up showed a 58% of soft tissues and prosthetic complications (on 137 implants) in TMD patients versus a 13% (on 130 implants) in non TMD patients. When TMD patients were undergone to occlusal overload prevention protocol, the complications were diminished to 15% (P< .001). The results indicate that increasing the number of implants and reducing cantilevers decreases the stress on each one; using the longest and widest implant possible increases implant/bone surface area and reduces also strain on the restorations. Also implant design, occlusal table size, the direction, duration and magnification of the forces influences the stress at the crestal bone/implant surface. Anterior guidance during excursive movements reduces forces and eliminate all lateral occlusal contact. Conclusion: Developing treatment plan that control the chronic bruxism through night-guards and modify the occlusal forces on implants and their restorations, patients with temporomandibular disorders and bruxism can be candidates for implants

Platelet-Rich Plasma (PRP) and freeze dried bone allograft (FDBA) as an adjunct to maxillofacial rehabilitation by means of zygomatic fixtures and bone autografts

Congrès de l’EAO (European Association for Osteointegration), Octobre 2009, MonacoFLWINinfo:eu-repo/semantics/publishedSpecial Issue: EAO 18th Annual Scientific Meeting Programme and Abstract