Patient selection: osteointegrated dental implant
Fracture of an osteointegrated dental implant is considered a late failure. Most fractures in osteointegrated implants occur in the mandibular and maxillary posterior regions.
Recommendations:
(1) use high quality materials
(2) use an implant with an optimum diameter, avoiding small diameters
(3) be sure that prosthetic planning is careful and thorough
(4) in areas at risk for excessive load, increase the number of implants and place them in a nonlinear configuration
(5) avoid metals that might result in galvanic activity
(6) select a posterior cantilever length appropriate for location and bone quality
The patient should be routinely monitored for:
(1) bruxism and other causes of large occlusal forces
(2) loosening and/or fracturing of the retaining screws (which may precede fracture)
(3) bone resorption around the implant (which may be a sign of overload)
(4) distribution of loads to ensure that these are well-balanced
