Journal of Oral Implantology April 2012 - (Page 194)

LITERATURE REVIEW Tooth-Implant Connection: A Review Oliver Hoffmann, DDS, MS1* Gregory-George Zafiropoulos, Dr Med Dent, Dr Habil2 The aim of this review was to assess the long-term outcomes of restorations supported by implants and natural teeth with regard to complications associated with implants, teeth, and restorations, as well as the influence on these parameters of the connector type used. A netbased search in PubMed was combined with a manual search. Clinical studies, reviews, and biomechanical studies were included. Information on survival rate, complication rate, incidence of tooth intrusion, and, where applicable, type of connector used, was retrieved from the clinical studies. Force distribution and types of connectors used were retrieved from the biomechanical study. A summary of outcomes was retrieved from the reviews. A total of 25 articles were selected for inclusion in this review, including clinical studies (15), biomechanical studies (7), and reviews (3). Implant success rates ranged from 79.5%–100%. Tooth complications occurred in 5.4%–11.8% of cases. Complications in the suprastructure were observed in 5%–90% of cases. Tooth intrusion presented in a total of 0%–66% of all cases, more often in cases with nonrigid connection (0%–66%) than in cases with rigid connection (0%–44%). Biomechanical studies show a large difference in stress distribution and in dependence on the type of connector used, with most studies demonstrating that nonrigid connectors drastically reduce stress on the suprastructure while increasing forces on supporting teeth and implants. Long-term success rates for tooth-implant connections are lower than for solely implant-supported restorations with regard to prognosis for teeth, implants, and suprastructure. Use of rigid connectors leads to more favorable clinical outcomes in terms of long-term stability, occurrence of complications, and tooth intrusion. Key Words: dental implants, fixed partial dentures INTRODUCTION uring past decades, implant treatment emerged as a widely accepted treatment modality with a reported long-term success rate greater than 90% for the treatment of both partially and completely edentulous patients.1 However, the combined use of teeth and implants as anchors for prosthetic restorations remains a controversial issue. 1 Department of Periodontics, Loma Linda University, Loma Linda, Calif. 2 Dental Center, ‘‘Blaues Haus,’’ Duesseldorf, Germany. * Corresponding author, e-mail: o_c_g_hoffmann@yahoo. com DOI: 10.1563/AAID-JOI-D-10-00071 D 194 Although implants become osseointegrated and thus have a rigid connection to supporting bone, teeth are supported by the periodontal ligament, allowing for physiologic mobility that leads to displacement of the crown of 50–200 m if forces of 0.1 N are applied.2 Implants, on the other hand, demonstrate maximum displacement of 10 m.3 A different behavior for masticatory forces results, leading to excessive load on the restoration, the abutments, and the implant. Complications such as fracture of mechanical parts and a higher incidence of caries at the crown margin and tooth intrusion have been described.4 The use of both rigid and nonrigid connectors of Vol. XXXVIII/No. Two/2012

Table of Contents for the Digital Edition of Journal of Oral Implantology April 2012

Research Letters: A New Editorial Format for the Rapid Disclosure of Innovative Data and Concepts, Didactic Demonstrations, and Scientific Discussions
Effect of Defective Collagen Synthesis on Epithelial Implant Interface: Lathyritic Model in Dogs. An Experimental Preliminary Study
Presence of Aspartate Aminotransferase in Peri-Implant Crevicular Fluid With and Without Mucositis
Deformation of Implant Abutments After Framework Connection Using Strain Gauges
Implant-Retained Mandibular Bar-Supported Overlay Dentures: A Finite Element Stress Analysis of Four Different Bar Heights
The Efficacy of Mylohyoid Nerve Anesthesia in Dental Implant Placement at the Edetulous Posterior Mandibular Ridge
Metal-Ceramic Screw-Retained Implant Fixed Partial Denture With Intraoral Luted Framework to Improve Passive Fit
A Relaxed Implant Bed: Implants Placed After Two Weeks of Osteotomy With Immediate Loading: A One Year Clinical Trial
A Modified Technique for Removing a Failed Abutment Screw From an Implant With a Custom Guide Tube
Therapy for Missing Lower Medial Incisor by Means of Reduced Diameter Implants
Simplifying the Implant Treatment Plan for an Elderly Patient
The Use of Leukocyte- and Platelet-Rich Fibrin During Immediate Postextractive Implantation and Loading for the Esthetic Replacement of a Fractured Maxillary Central Incisor
Atraumatic Removal of an Asymptomatic Migrated Dental Implant Into the Maxillary Sinus: A Case Report
Tooth-Implant Connection: A Review

Journal of Oral Implantology April 2012