İmplant Üstü Protezlerde Komplikasyonlar
Özet
Bu bölüm, implant destekli protezlerde görülen komplikasyonların kapsamlı bir değerlendirmesini sunmaktadır. Dental implantlar yüksek sağkalım oranlarına sahip olsa da, implantın ağızda kalması her zaman komplikasyonsuz bir tedavi anlamına gelmemektedir. Bu nedenle implant tedavisinin başarısı yalnızca sağkalım oranlarıyla değil, ortaya çıkabilecek biyolojik, mekanik, teknik ve cerrahi komplikasyonların değerlendirilmesiyle birlikte ele alınmalıdır. Bölümde cerrahi komplikasyonlar (hemoraji, nörosensoryel bozukluklar), biyolojik komplikasyonlar (marjinal kemik kaybı, peri-implant doku problemleri), mekanik komplikasyonlar (vida gevşemesi, abutment ve implant kırıkları) ve teknik komplikasyonlar (veneer kırıkları, retansiyon kaybı) ayrıntılı olarak incelenmektedir. Ayrıca komplikasyonların protez tipine göre farklılık gösterebileceği; implant destekli sabit protezler, overdenture protezler, sabit parsiyel protezler ve tek kron restorasyonlar açısından değerlendirme yapılmaktadır. Komplikasyonların etiyolojisi, risk faktörleri ve klinik yönetim yaklaşımları ele alınarak implant tedavisinin uzun dönem başarısının yalnızca osseointegrasyonla sınırlı olmadığı vurgulanmaktadır. Sonuç olarak, doğru hasta seçimi, uygun cerrahi ve protetik planlama ile düzenli bakım protokollerinin komplikasyonların önlenmesinde ve implant rehabilitasyonunun sürdürülebilir başarısında kritik rol oynadığı belirtilmektedir.
This chapter provides a comprehensive overview of complications associated with implant-supported prostheses. Although dental implants demonstrate high survival rates, implant survival alone does not necessarily indicate a complication-free treatment outcome. Therefore, the success of implant therapy should be evaluated not only by survival rates but also by the occurrence and management of biological, mechanical, technical, and surgical complications. The chapter discusses surgical complications such as hemorrhage and neurosensory disturbances; biological complications including marginal bone loss and peri-implant soft tissue conditions; mechanical complications such as screw loosening and fractures of abutments or implants; and technical complications including veneer fractures and loss of retention. Additionally, complications are analyzed according to the type of implant prosthesis, including implant-supported fixed complete dentures, overdentures, fixed partial dentures, and single-crown restorations. The etiological factors, risk indicators, and clinical management strategies for these complications are also addressed. Overall, the chapter emphasizes that long-term success in implant therapy depends not only on osseointegration but also on maintaining biological stability, mechanical integrity, and prosthetic durability through appropriate patient selection, careful treatment planning, and regular maintenance protocols.
Referanslar
Buser D, Chappuis V, Belser UC, Chen S. Implant placement post extraction in esthetic single tooth sites: when immediate, when early, when late? Periodontol 2000. 2017;73(1):84-102.
Gallucci GO, Hamilton A, Zhou W, Buser D, Chen S. Implant placement and loading protocols in partially edentulous patients: a systematic review. Clin Oral Implant Res. 2018;29 (Suppl 16): 106-134.
Zitzmann NU, Marinello CP. A review of clinical and technical considerations for fixed and removable implant prostheses in the edentulous mandible. Int J Prosthodont. 2002;15(1):65-72.
Di Francesco F, De Marco G, Gironi Carnevale UA, Lanza M, Lanza A. The number of implants required to support a maxillary overdenture: a systematic review and meta-analysis. J Prosthodont Res. 2019;63(1):15-24.
Jung RE, Zembic A, Pjetursson BE, Zwahlen M, Thoma DS. Systematic review of the survival rate and the incidence of biological, technical, and aesthetic complications of single crowns on implants reported in longitudinal studies with a mean follow-up of 5 years. Clin Oral Implant Res. 2012;23(Suppl 6):2-21.
Papaspyridakos P, Chen CJ, Chuang SK, Weber HP, Gallucci GO. A systematic review of biologic and technical complications with fixed implant rehabilitations for edentulous patients. Int J Oral Maxillofac Implants. 2012;27(1):102-110.
Goodacre CJ, Bernal G, Rungcharassaeng K, Kan JYK. Clinical complications with implants and implant prostheses. J Prosthet Dent. 2003;90(2):121-132.
Pjetursson BE, Thoma D, Jung R, Zwahlen M, Zembic A. A systematic review of the survival and complication rates of implant-supported fixed dental prostheses (FDPs) after a mean observation period of at least 5 years. Clin Oral Implants Res. 2012;23(Suppl 6):22-9. 9.Papaspyridakos P, Chen CJ, Singh M, Weber HP, Gallucci GO. Success criteria in implant dentistry: a systematic review. J Dent Res. 2012;91(3):242-248.
Jung RE, Zembic A, Pjetursson BE, Zwahlen M, Thoma DS. Systematic review of the survival rate and complications of single crowns supported by implants. Clin Oral Implants Res. 2012;23(Suppl 6):2-21.
Tan K, Pjetursson BE, Lang NP, Chan ESY. A systematic review of the survival and complication rates of fixed partial dentures (FPDs) after an observation period of at least 5 years. Clin Oral Implants Res. 2004;15(6):654-666.
Buser D, Martin W, Belser UC. Optimizing esthetics for implant restorations in the anterior maxilla: anatomic and surgical considerations. Int J Oral Maxillofac Implants. 2004;19(Suppl):43-61.
Kalpidis CDR, Setayesh RM. Hemorrhaging associated with endosseous implant placement in the anterior mandible: a review of the literature. J Periodontol. 2004;75(5):631-645.
Juodzbalys G, Wang HL, Sabalys G. Injury of the inferior alveolar nerve during implant placement: a literature review. J Oral Maxillofac Res. 2011;2(1):e1.
Hillerup S. Iatrogenic injury to oral branches of the trigeminal nerve: records of 449 cases. Clin Oral Investig. 2007;11(2):133-142.
Greenstein G, Tarnow D. The mental foramen and nerve: clinical and anatomical factors related to dental implant placement. J Periodontol. 2006;77(12):1933-1943.
Renton T. Prevention of iatrogenic inferior alveolar nerve injuries in relation to dental procedures. Dent Update. 2010;37(6):350-363.
Chrcanovic BR, Albrektsson T, Wennerberg A. Smoking and dental implants: a systematic review and meta-analysis. J Dent. 2015;43(5):487-498.
Claudy MP, Miguens SAQ Jr, Celeste RK, Camara Parente R, Hernandez PAG, da Silva AN Jr. Time interval after radiotherapy and dental implant failure: systematic review of observational studies and meta-analysis. Clin Implant Dent Relat Res. 2015;17(2):402-411.
Chrcanovic BR, Albrektsson T, Wennerberg A. Diabetes and oral implant failure: a systematic review. J Dent Res. 2014;93(9):859-867.
Jaffin RA, Berman CL. The excessive loss of Brånemark fixtures in type IV bone: a 5-year analysis. J Periodontol. 1991;62(1):2-4.
Berglundh T, Armitage G, Araujo MG, Avila-Ortiz G, Blanco J, Camargo PM, et al. Peri-implant diseases and conditions: Consensus report of workgroup 4 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Clin Periodontol. 2018;45(Suppl 20):S286-S291.
Albrektsson T, Zarb G, Worthington P, Eriksson AR. The long-term efficacy of currently used dental implants: a review and proposed criteria of success. Int J Oral Maxillofac Implants. 1986;1(1):11-25.
Laurell L, Lundgren D. Marginal bone level changes at dental implants after 5 years in function: a meta-analysis. Clin Implant Dent Relat Res. 2011;13(1):19-28.
Heitz-Mayfield LJA, Salvi GE. Peri-implant mucositis. J Clin Periodontol. 2018;45(Suppl 20):S237-S245.
Berglundh T, Lindhe J, Ericsson I, Marinello CP, Liljenberg B, Thomsen P. The soft tissue barrier at implants and teeth. Clin Oral Implants Res. 1991;2(2):81-90.
Canallatos JE, Hobbs GR, Bryington M, Dye BD. The effect of implant prosthesis complications on patient satisfaction. J Prosthet Dent. 2020;124(1):84–90.
Ruggiero SL, Dodson TB, Aghaloo T, Carlson ER, Ward BB, Kademani D. Medication-related osteonecrosis of the jaw—2022 update. Position paper from the American Association of Oral and Maxillofacial Surgeons. J Oral Maxillofac Surg. 2022;80(5):920-943.
Chronopoulos A, et al. Osteoradionecrosis of the jaws: definition, epidemiology, staging and clinical and radiological findings — a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol. 2018;125(6):612–628.
Schwarz F, Derks J, Monje A, Wang HL. Peri-implantitis. J Clin Periodontol. 2018;45(Suppl 20):S246-S266.
Binon PP. Implants and components: entering the new millennium. Int J Oral Maxillofac Implants. 2000;15(1):76-94.
Misch CE, Suzuki JB, Misch-Dietsh FM, Bidez MW. A positive correlation between occlusal trauma and peri-implant bone loss: literature support. Implant Dent. 2005;14(2):108-116.
Misch CE, Bidez MW. Implant-protected occlusion: a biomechanical rationale. Compend Contin Educ Dent. 1994;15(11):1330-1344.
Chrcanovic BR, Kisch J, Albrektsson T, Wennerberg A. Factors influencing the fracture of dental implants. Clin Implant Dent Relat Res. 2018;20(1):58-67.
Teixeira ES, Bonfante EA, Silva NRFA, et al. Biomechanical influence of bone quality and crestal cortical bone on dental implant stability: A three-dimensional finite element analysis. J Prosthet Dent. 2011;106(1):30-38.
Choe HC, Kim YS, Son MK. Fatigue fracture of titanium dental implants: an in vitro and fractographic analysis. J Biomed Mater Res B Appl Biomater. 2007;81(2):351-356.
Pjetursson BE, Tan K, Lang NP, Brägger U, Zwahlen M. A systematic review of the survival and complication rates of implant-supported fixed partial dentures (FPDs) after an observation period of at least 5 years. Clin Oral Implants Res. 2004;15(6):625-642.
Sailer I, Pjetursson BE, Zwahlen M, Hämmerle CHF. A systematic review of the survival and complication rates of all-ceramic and metal-ceramic reconstructions after an observation period of at least 3 years. Clin Oral Implants Res. 2007;18(Suppl 3):86-96.
Denry I, Kelly JR. State of the art of zirconia for dental applications. Dent Mater. 2008;24(3):299-307.
Sailer I, Makarov NA, Thoma DS, Zwahlen M, Pjetursson BE. All-ceramic or metal–ceramic tooth-supported fixed dental prostheses (FDPs)? A systematic review of the survival and complication rates. Part I: Single crowns. Dent Mater. 2015;31(6):603-623.
Bernal G, Okamura M, Muñoz CA. The effects of abutment taper and cement type on the retention of implant-supported crowns. Int J Prosthodont. 2003;16(6):643-648.
Wilson TG Jr. The positive relationship between excess cement and peri-implant disease: a prospective clinical endoscopic study. J Periodontol. 2009;80(9):1388-1392.
Pjetursson BE, Brägger U, Lang NP, Zwahlen M. Comparison of survival and complication rates of tooth-supported fixed dental prostheses (FDPs) and implant-supported FDPs and single crowns (SCs). Clin Oral Implants Res. 2007;18(Suppl 3):97-113.
Brånemark PI, Svensson B, van Steenberghe D. Ten-year survival rates of fixed prostheses on four or six implants ad modum Brånemark in full edentulism. Clin Oral Implants Res. 1995;6(4):227-231.
Feine JS, Carlsson GE, Awad MA, Chehade A, Duncan WJ, Gizani S, et al. The McGill consensus statement on overdentures. Mandibular two-implant overdentures as first choice standard of care for edentulous patients. Int J Oral Maxillofac Implants. 2002;17(4):601-602.
Referanslar
Buser D, Chappuis V, Belser UC, Chen S. Implant placement post extraction in esthetic single tooth sites: when immediate, when early, when late? Periodontol 2000. 2017;73(1):84-102.
Gallucci GO, Hamilton A, Zhou W, Buser D, Chen S. Implant placement and loading protocols in partially edentulous patients: a systematic review. Clin Oral Implant Res. 2018;29 (Suppl 16): 106-134.
Zitzmann NU, Marinello CP. A review of clinical and technical considerations for fixed and removable implant prostheses in the edentulous mandible. Int J Prosthodont. 2002;15(1):65-72.
Di Francesco F, De Marco G, Gironi Carnevale UA, Lanza M, Lanza A. The number of implants required to support a maxillary overdenture: a systematic review and meta-analysis. J Prosthodont Res. 2019;63(1):15-24.
Jung RE, Zembic A, Pjetursson BE, Zwahlen M, Thoma DS. Systematic review of the survival rate and the incidence of biological, technical, and aesthetic complications of single crowns on implants reported in longitudinal studies with a mean follow-up of 5 years. Clin Oral Implant Res. 2012;23(Suppl 6):2-21.
Papaspyridakos P, Chen CJ, Chuang SK, Weber HP, Gallucci GO. A systematic review of biologic and technical complications with fixed implant rehabilitations for edentulous patients. Int J Oral Maxillofac Implants. 2012;27(1):102-110.
Goodacre CJ, Bernal G, Rungcharassaeng K, Kan JYK. Clinical complications with implants and implant prostheses. J Prosthet Dent. 2003;90(2):121-132.
Pjetursson BE, Thoma D, Jung R, Zwahlen M, Zembic A. A systematic review of the survival and complication rates of implant-supported fixed dental prostheses (FDPs) after a mean observation period of at least 5 years. Clin Oral Implants Res. 2012;23(Suppl 6):22-9. 9.Papaspyridakos P, Chen CJ, Singh M, Weber HP, Gallucci GO. Success criteria in implant dentistry: a systematic review. J Dent Res. 2012;91(3):242-248.
Jung RE, Zembic A, Pjetursson BE, Zwahlen M, Thoma DS. Systematic review of the survival rate and complications of single crowns supported by implants. Clin Oral Implants Res. 2012;23(Suppl 6):2-21.
Tan K, Pjetursson BE, Lang NP, Chan ESY. A systematic review of the survival and complication rates of fixed partial dentures (FPDs) after an observation period of at least 5 years. Clin Oral Implants Res. 2004;15(6):654-666.
Buser D, Martin W, Belser UC. Optimizing esthetics for implant restorations in the anterior maxilla: anatomic and surgical considerations. Int J Oral Maxillofac Implants. 2004;19(Suppl):43-61.
Kalpidis CDR, Setayesh RM. Hemorrhaging associated with endosseous implant placement in the anterior mandible: a review of the literature. J Periodontol. 2004;75(5):631-645.
Juodzbalys G, Wang HL, Sabalys G. Injury of the inferior alveolar nerve during implant placement: a literature review. J Oral Maxillofac Res. 2011;2(1):e1.
Hillerup S. Iatrogenic injury to oral branches of the trigeminal nerve: records of 449 cases. Clin Oral Investig. 2007;11(2):133-142.
Greenstein G, Tarnow D. The mental foramen and nerve: clinical and anatomical factors related to dental implant placement. J Periodontol. 2006;77(12):1933-1943.
Renton T. Prevention of iatrogenic inferior alveolar nerve injuries in relation to dental procedures. Dent Update. 2010;37(6):350-363.
Chrcanovic BR, Albrektsson T, Wennerberg A. Smoking and dental implants: a systematic review and meta-analysis. J Dent. 2015;43(5):487-498.
Claudy MP, Miguens SAQ Jr, Celeste RK, Camara Parente R, Hernandez PAG, da Silva AN Jr. Time interval after radiotherapy and dental implant failure: systematic review of observational studies and meta-analysis. Clin Implant Dent Relat Res. 2015;17(2):402-411.
Chrcanovic BR, Albrektsson T, Wennerberg A. Diabetes and oral implant failure: a systematic review. J Dent Res. 2014;93(9):859-867.
Jaffin RA, Berman CL. The excessive loss of Brånemark fixtures in type IV bone: a 5-year analysis. J Periodontol. 1991;62(1):2-4.
Berglundh T, Armitage G, Araujo MG, Avila-Ortiz G, Blanco J, Camargo PM, et al. Peri-implant diseases and conditions: Consensus report of workgroup 4 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Clin Periodontol. 2018;45(Suppl 20):S286-S291.
Albrektsson T, Zarb G, Worthington P, Eriksson AR. The long-term efficacy of currently used dental implants: a review and proposed criteria of success. Int J Oral Maxillofac Implants. 1986;1(1):11-25.
Laurell L, Lundgren D. Marginal bone level changes at dental implants after 5 years in function: a meta-analysis. Clin Implant Dent Relat Res. 2011;13(1):19-28.
Heitz-Mayfield LJA, Salvi GE. Peri-implant mucositis. J Clin Periodontol. 2018;45(Suppl 20):S237-S245.
Berglundh T, Lindhe J, Ericsson I, Marinello CP, Liljenberg B, Thomsen P. The soft tissue barrier at implants and teeth. Clin Oral Implants Res. 1991;2(2):81-90.
Canallatos JE, Hobbs GR, Bryington M, Dye BD. The effect of implant prosthesis complications on patient satisfaction. J Prosthet Dent. 2020;124(1):84–90.
Ruggiero SL, Dodson TB, Aghaloo T, Carlson ER, Ward BB, Kademani D. Medication-related osteonecrosis of the jaw—2022 update. Position paper from the American Association of Oral and Maxillofacial Surgeons. J Oral Maxillofac Surg. 2022;80(5):920-943.
Chronopoulos A, et al. Osteoradionecrosis of the jaws: definition, epidemiology, staging and clinical and radiological findings — a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol. 2018;125(6):612–628.
Schwarz F, Derks J, Monje A, Wang HL. Peri-implantitis. J Clin Periodontol. 2018;45(Suppl 20):S246-S266.
Binon PP. Implants and components: entering the new millennium. Int J Oral Maxillofac Implants. 2000;15(1):76-94.
Misch CE, Suzuki JB, Misch-Dietsh FM, Bidez MW. A positive correlation between occlusal trauma and peri-implant bone loss: literature support. Implant Dent. 2005;14(2):108-116.
Misch CE, Bidez MW. Implant-protected occlusion: a biomechanical rationale. Compend Contin Educ Dent. 1994;15(11):1330-1344.
Chrcanovic BR, Kisch J, Albrektsson T, Wennerberg A. Factors influencing the fracture of dental implants. Clin Implant Dent Relat Res. 2018;20(1):58-67.
Teixeira ES, Bonfante EA, Silva NRFA, et al. Biomechanical influence of bone quality and crestal cortical bone on dental implant stability: A three-dimensional finite element analysis. J Prosthet Dent. 2011;106(1):30-38.
Choe HC, Kim YS, Son MK. Fatigue fracture of titanium dental implants: an in vitro and fractographic analysis. J Biomed Mater Res B Appl Biomater. 2007;81(2):351-356.
Pjetursson BE, Tan K, Lang NP, Brägger U, Zwahlen M. A systematic review of the survival and complication rates of implant-supported fixed partial dentures (FPDs) after an observation period of at least 5 years. Clin Oral Implants Res. 2004;15(6):625-642.
Sailer I, Pjetursson BE, Zwahlen M, Hämmerle CHF. A systematic review of the survival and complication rates of all-ceramic and metal-ceramic reconstructions after an observation period of at least 3 years. Clin Oral Implants Res. 2007;18(Suppl 3):86-96.
Denry I, Kelly JR. State of the art of zirconia for dental applications. Dent Mater. 2008;24(3):299-307.
Sailer I, Makarov NA, Thoma DS, Zwahlen M, Pjetursson BE. All-ceramic or metal–ceramic tooth-supported fixed dental prostheses (FDPs)? A systematic review of the survival and complication rates. Part I: Single crowns. Dent Mater. 2015;31(6):603-623.
Bernal G, Okamura M, Muñoz CA. The effects of abutment taper and cement type on the retention of implant-supported crowns. Int J Prosthodont. 2003;16(6):643-648.
Wilson TG Jr. The positive relationship between excess cement and peri-implant disease: a prospective clinical endoscopic study. J Periodontol. 2009;80(9):1388-1392.
Pjetursson BE, Brägger U, Lang NP, Zwahlen M. Comparison of survival and complication rates of tooth-supported fixed dental prostheses (FDPs) and implant-supported FDPs and single crowns (SCs). Clin Oral Implants Res. 2007;18(Suppl 3):97-113.
Brånemark PI, Svensson B, van Steenberghe D. Ten-year survival rates of fixed prostheses on four or six implants ad modum Brånemark in full edentulism. Clin Oral Implants Res. 1995;6(4):227-231.
Feine JS, Carlsson GE, Awad MA, Chehade A, Duncan WJ, Gizani S, et al. The McGill consensus statement on overdentures. Mandibular two-implant overdentures as first choice standard of care for edentulous patients. Int J Oral Maxillofac Implants. 2002;17(4):601-602.
