Factors influencing the fracture of dental implants

Background: Implant fractures are rare but offer a challenging clinical situation. Purpose: To determine the prevalence of implant fracture and the possible risk factors predisposing an implant to a higher fracture risk. Materials and Methods: This retrospective study is based on 2670 patients consecutively treated with implant-supported prostheses. Anatomical-, patient-, and implant-related factors were collected. Descriptive statistics and survival analyses were performed. Generalized estimating equations (GEE) evaluated the effect of explanatory variables on implant fracture. Results: Forty-four implants (out of 10 099; 0.44%) fractured. The mean ± standard deviation time for fracture to occur was 95.1 ± 58.5 months (min-max, 3.8-294.7). Half of the occurrences of fracture happened between 2 and 8 years after implantation. Five factors had a statistically significant influence on the fracture of implants (increase/decrease in fracture probability): use of higher grades of titanium (decrease 72.9%), bruxism (increase 1819.5%), direct adjacency to cantilever (increase 247.6%), every 1 mm increase in implant length (increase 22.3%), every 1 mm increase in implant diameter (decrease 96.9%). Conclusions: It is suggested that 5 factors could influence the incidence of implant fractures: grade of titanium, implant diameter and length, cantilever, bruxism