Fractured zirconia implants and related implant designs: scanning electron microscopy analysis
Identifieur interne : 003032 ( Istex/Corpus ); précédent : 003031; suivant : 003033Fractured zirconia implants and related implant designs: scanning electron microscopy analysis
Auteurs : Reham B. Osman ; Sunyoung Ma ; Warwick Duncan ; Rohana K. De Silva ; Allauddin Siddiqi ; Michael V. SwainSource :
- Clinical Oral Implants Research [ 0905-7161 ] ; 2013-05.
English descriptors
- KwdEn :
- Arrest lines, Case report, Ceramic implants, Clinical implant dentistry, Concave side, Crack front, Crack initiation, Crack propagation, Crestal, Crestal implant, Denry kelly, Dense bone, Dental implant design, Dental implants, Dental materials, Dentistry, Design features, Failure mechanisms, Fracture, Fracture mirror region, Fracture origin, Fracture site, Fracture surfaces, Hackle, Hackle lines, Hand torque, Implant, Implant body, Implant dentistry, Implant design, Implant designs, Implant dimensions, Implant failure, Implant fracture, Implant placement, Implant site, Implants research, International journal, John wiley sons osman, Kelly, Kohal, Literature review, Manufacturing imperfections, Oral impl, Oral implantology, Oral implants, Oral maxillofacial implants, Osman, Osseointegration, Potential causes, Prosthetic dentistry, Quinn, Replacement implant, Scanning electron microscope, Scanning electron microscope images, Secondary cracks, Sharp thread edge, Smooth region, Solid arrows, Southern implants, Strict quality control, Such incidences, Surgical, Surgical placement, Surgical protocols, Surgical trephine, Systematic review, Thread design, Titanium, Titanium allergy, Titanium implants, Virdee bishop, Zirconia, Zirconia implants.
- Teeft :
- Arrest lines, Case report, Ceramic implants, Clinical implant dentistry, Concave side, Crack front, Crack initiation, Crack propagation, Crestal, Crestal implant, Denry kelly, Dense bone, Dental implant design, Dental implants, Dental materials, Dentistry, Design features, Failure mechanisms, Fracture, Fracture mirror region, Fracture origin, Fracture site, Fracture surfaces, Hackle, Hackle lines, Hand torque, Implant, Implant body, Implant dentistry, Implant design, Implant designs, Implant dimensions, Implant failure, Implant fracture, Implant placement, Implant site, Implants research, International journal, John wiley sons osman, Kelly, Kohal, Literature review, Manufacturing imperfections, Oral impl, Oral implantology, Oral implants, Oral maxillofacial implants, Osman, Osseointegration, Potential causes, Prosthetic dentistry, Quinn, Replacement implant, Scanning electron microscope, Scanning electron microscope images, Secondary cracks, Sharp thread edge, Smooth region, Solid arrows, Southern implants, Strict quality control, Such incidences, Surgical, Surgical placement, Surgical protocols, Surgical trephine, Systematic review, Thread design, Titanium, Titanium allergy, Titanium implants, Virdee bishop, Zirconia, Zirconia implants.
Abstract
Two fractured one‐piece experimental (commercially unavailable) zirconia implants were analyzed using scanning electron microscope (SEM) analysis to identify failure origins and aid in understanding the failure mechanisms. Modifications to the zirconia implant design are suggested to minimize such fracture incidences.
Url:
DOI: 10.1111/j.1600-0501.2011.02411.x
Links to Exploration step
ISTEX:62341CCECCBFDB314F9F3BBE2B42E1A3900C005ELe document en format XML
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report</term><term>Ceramic implants</term><term>Clinical implant dentistry</term><term>Concave side</term><term>Crack front</term><term>Crack initiation</term><term>Crack propagation</term><term>Crestal</term><term>Crestal implant</term><term>Denry kelly</term><term>Dense bone</term><term>Dental implant design</term><term>Dental implants</term><term>Dental materials</term><term>Dentistry</term><term>Design features</term><term>Failure mechanisms</term><term>Fracture</term><term>Fracture mirror region</term><term>Fracture origin</term><term>Fracture site</term><term>Fracture surfaces</term><term>Hackle</term><term>Hackle lines</term><term>Hand torque</term><term>Implant</term><term>Implant body</term><term>Implant dentistry</term><term>Implant design</term><term>Implant designs</term><term>Implant dimensions</term><term>Implant failure</term><term>Implant fracture</term><term>Implant placement</term><term>Implant site</term><term>Implants research</term><term>International journal</term><term>John wiley sons osman</term><term>Kelly</term><term>Kohal</term><term>Literature review</term><term>Manufacturing imperfections</term><term>Oral impl</term><term>Oral implantology</term><term>Oral implants</term><term>Oral maxillofacial implants</term><term>Osman</term><term>Osseointegration</term><term>Potential causes</term><term>Prosthetic dentistry</term><term>Quinn</term><term>Replacement implant</term><term>Scanning electron microscope</term><term>Scanning electron microscope images</term><term>Secondary cracks</term><term>Sharp thread edge</term><term>Smooth region</term><term>Solid arrows</term><term>Southern implants</term><term>Strict quality control</term><term>Such incidences</term><term>Surgical</term><term>Surgical placement</term><term>Surgical protocols</term><term>Surgical trephine</term><term>Systematic review</term><term>Thread design</term><term>Titanium</term><term>Titanium allergy</term><term>Titanium implants</term><term>Virdee bishop</term><term>Zirconia</term><term>Zirconia implants</term></keywords><keywords scheme="Teeft" xml:lang="en"><term>Arrest lines</term><term>Case report</term><term>Ceramic implants</term><term>Clinical implant dentistry</term><term>Concave side</term><term>Crack front</term><term>Crack initiation</term><term>Crack propagation</term><term>Crestal</term><term>Crestal implant</term><term>Denry kelly</term><term>Dense bone</term><term>Dental implant design</term><term>Dental implants</term><term>Dental materials</term><term>Dentistry</term><term>Design features</term><term>Failure mechanisms</term><term>Fracture</term><term>Fracture mirror region</term><term>Fracture origin</term><term>Fracture site</term><term>Fracture surfaces</term><term>Hackle</term><term>Hackle lines</term><term>Hand torque</term><term>Implant</term><term>Implant body</term><term>Implant dentistry</term><term>Implant design</term><term>Implant designs</term><term>Implant dimensions</term><term>Implant 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review</term><term>Thread design</term><term>Titanium</term><term>Titanium allergy</term><term>Titanium implants</term><term>Virdee bishop</term><term>Zirconia</term><term>Zirconia implants</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract">Two fractured one‐piece experimental (commercially unavailable) zirconia implants were analyzed using scanning electron microscope (SEM) analysis to identify failure origins and aid in understanding the failure mechanisms. 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Osman</name><affiliations><json:string>Oral Implantology Research Group, School of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand</json:string></affiliations></json:item><json:item><name>Sunyoung Ma</name><affiliations><json:string>Oral Implantology Research Group, School of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand</json:string><json:string>Dr Sunyoung MaSir John Walsh Research InstituteSchool of Dentistry, University of Otago280 Great King StreetDunedin, New ZealandTel.: +64 3 4797044Fax: +64 3 479 5079e‐mail:</json:string><json:string>E-mail: sunyoung.ma@otago.ac.nz</json:string></affiliations></json:item><json:item><name>Warwick Duncan</name><affiliations><json:string>Oral Implantology Research Group, School of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand</json:string></affiliations></json:item><json:item><name>Rohana K. De Silva</name><affiliations><json:string>Oral Implantology Research Group, School of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand</json:string></affiliations></json:item><json:item><name>Allauddin Siddiqi</name><affiliations><json:string>Oral Implantology Research Group, School of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand</json:string></affiliations></json:item><json:item><name>Michael V. Swain</name><affiliations><json:string>Oral Implantology Research Group, School of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand</json:string></affiliations></json:item></author><articleId><json:string>CLR2411</json:string></articleId><arkIstex>ark:/67375/WNG-0GVW3QDX-1</arkIstex><language><json:string>eng</json:string></language><originalGenre><json:string>caseStudy</json:string></originalGenre><abstract>Two fractured one‐piece experimental (commercially unavailable) zirconia implants were analyzed using scanning electron microscope (SEM) analysis to identify failure origins and aid in understanding the failure mechanisms. Modifications to the zirconia implant design are suggested to minimize such fracture incidences.</abstract><qualityIndicators><score>6.183</score><pdfWordCount>3703</pdfWordCount><pdfCharCount>23317</pdfCharCount><pdfVersion>1.3</pdfVersion><pdfPageCount>6</pdfPageCount><pdfPageSize>595.276 x 782.362 pts</pdfPageSize><refBibsNative>true</refBibsNative><abstractWordCount>40</abstractWordCount><abstractCharCount>319</abstractCharCount><keywordCount>0</keywordCount></qualityIndicators><title>Fractured zirconia implants and related implant designs: scanning electron microscopy analysis</title><pmid><json:string>22276596</json:string></pmid><genre><json:string>case-report</json:string></genre><host><title>Clinical Oral Implants Research</title><language><json:string>unknown</json:string></language><doi><json:string>10.1111/(ISSN)1600-0501</json:string></doi><issn><json:string>0905-7161</json:string></issn><eissn><json:string>1600-0501</json:string></eissn><publisherId><json:string>CLR</json:string></publisherId><volume>24</volume><issue>5</issue><pages><first>592</first><last>597</last><total>6</total></pages><genre><json:string>journal</json:string></genre><subject><json:item><value>Case Report</value></json:item></subject></host><namedEntities><unitex><date><json:string>2012-01-02</json:string><json:string>From November 2009 to July 2011</json:string></date><geogName></geogName><orgName><json:string>University of Otago</json:string><json:string>University of Otago</json:string><json:string>University of Otago Postgraduate Scholarship</json:string><json:string>New Zealand and Kate Sheppard Memorial Trust Scholarship</json:string><json:string>Dunedin</json:string></orgName><orgName_funder><json:string>University of Otago</json:string><json:string>University of Otago Postgraduate Scholarship</json:string><json:string>New Zealand and Kate Sheppard Memorial Trust Scholarship</json:string><json:string>Dunedin</json:string></orgName_funder><orgName_provider></orgName_provider><persName><json:string>G.T. 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(1989)</json:string><json:string>Gahlert et al. 2011</json:string><json:string>Green et al. 2002</json:string><json:string>Lekholm & Zarb 1985</json:string><json:string>Denry & Kelly 2008</json:string><json:string>Kohal et al. 2008</json:string><json:string>Heydecke et al. 1999</json:string><json:string>Quinn 2007</json:string><json:string>Velasquez-Plata et al. 2002</json:string><json:string>Hall et al. 2005</json:string><json:string>Javed et al. 2011</json:string><json:string>Siddiqi et al. 2011</json:string><json:string>Sennerby et al. 2005</json:string><json:string>Wenz et al. 2008</json:string><json:string>Brunski 1988</json:string><json:string>Wennerberg & Albrektsson 2009</json:string><json:string>Piconi & Maccauro 1999</json:string><json:string>Quinn et al. 2005</json:string><json:string>Scarano et al. 2003</json:string><json:string>Manda et al. 2009</json:string><json:string>Sicilia et al. 2008</json:string><json:string>Osman et al.</json:string><json:string>Andreiotelli et al. 2009</json:string><json:string>Andreiotelli & Kohal 2009</json:string><json:string>Steigenga et al. 2003</json:string><json:string>Scherrer et al. 2006</json:string><json:string>Vandeweghe et al. 2010</json:string><json:string>Piattelli et al. 1998</json:string></ref_bibl><bibl></bibl></unitex></namedEntities><ark><json:string>ark:/67375/WNG-0GVW3QDX-1</json:string></ark><categories><wos><json:string>1 - science</json:string><json:string>2 - engineering, biomedical</json:string><json:string>2 - dentistry, oral surgery & medicine</json:string></wos><scienceMetrix><json:string>1 - health sciences</json:string><json:string>2 - clinical medicine</json:string><json:string>3 - dentistry</json:string></scienceMetrix><scopus><json:string>1 - Health Sciences</json:string><json:string>2 - Dentistry</json:string><json:string>3 - Oral 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analysis</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Wiley Publishing Ltd</publisher><availability><licence>© 2012 John Wiley & Sons A/S</licence></availability><date type="published" when="2013-05"></date></publicationStmt><notesStmt><note type="content-type" subtype="case-report" source="caseStudy" scheme="https://content-type.data.istex.fr/ark:/67375/XTP-29919SZJ-6">case-report</note><note type="publication-type" subtype="journal" scheme="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</note></notesStmt><sourceDesc><biblStruct type="case-report"><analytic><title level="a" type="main">Fractured zirconia implants and related implant designs: scanning electron microscopy analysis</title><author xml:id="author-0000"><persName><forename type="first">Reham B.</forename><surname>Osman</surname></persName><affiliation><orgName>Oral Implantology Research Group</orgName><orgName>School of Dentistry</orgName><orgName>Sir John Walsh Research Institute</orgName><orgName>University of Otago</orgName><address><settlement type="city">Dunedin</settlement><country key="NZ">New Zealand</country></address></affiliation></author><author xml:id="author-0001" role="corresp"><persName><forename type="first">Sunyoung</forename><surname>Ma</surname></persName><affiliation><orgName>Oral Implantology Research Group</orgName><orgName>School of Dentistry</orgName><orgName>Sir John Walsh Research Institute</orgName><orgName>University of Otago</orgName><address><settlement type="city">Dunedin</settlement><country key="NZ">New Zealand</country></address></affiliation><affiliation>Corresponding author: Dr Sunyoung Ma Sir John Walsh Research Institute School of Dentistry, University of Otago 280 Great King Street Dunedin, New Zealand Tel.: +64 3 4797044 Fax: +64 3 479 5079 e‐mail: sunyoung.ma@otago.ac.nz</affiliation></author><author xml:id="author-0002"><persName><forename type="first">Warwick</forename><surname>Duncan</surname></persName><affiliation><orgName>Oral Implantology Research Group</orgName><orgName>School of Dentistry</orgName><orgName>Sir John Walsh Research Institute</orgName><orgName>University of Otago</orgName><address><settlement type="city">Dunedin</settlement><country key="NZ">New Zealand</country></address></affiliation></author><author xml:id="author-0003"><persName><forename type="first">Rohana K.</forename><surname>De Silva</surname></persName><affiliation><orgName>Oral Implantology Research Group</orgName><orgName>School of Dentistry</orgName><orgName>Sir John Walsh Research Institute</orgName><orgName>University of Otago</orgName><address><settlement type="city">Dunedin</settlement><country key="NZ">New Zealand</country></address></affiliation></author><author xml:id="author-0004"><persName><forename type="first">Allauddin</forename><surname>Siddiqi</surname></persName><affiliation><orgName>Oral Implantology Research Group</orgName><orgName>School of Dentistry</orgName><orgName>Sir John Walsh Research Institute</orgName><orgName>University of Otago</orgName><address><settlement type="city">Dunedin</settlement><country key="NZ">New Zealand</country></address></affiliation></author><author xml:id="author-0005"><persName><forename type="first">Michael V.</forename><surname>Swain</surname></persName><affiliation><orgName>Oral Implantology Research Group</orgName><orgName>School of Dentistry</orgName><orgName>Sir John Walsh Research Institute</orgName><orgName>University of Otago</orgName><address><settlement type="city">Dunedin</settlement><country key="NZ">New Zealand</country></address></affiliation></author><idno type="istex">62341CCECCBFDB314F9F3BBE2B42E1A3900C005E</idno><idno type="ark">ark:/67375/WNG-0GVW3QDX-1</idno><idno type="DOI">10.1111/j.1600-0501.2011.02411.x</idno><idno type="unit">CLR2411</idno><idno type="toTypesetVersion">file:CLR.CLR2411.pdf</idno></analytic><monogr><title level="j" type="main">Clinical Oral Implants Research</title><title level="j" type="alt">CLINICAL ORAL IMPLANTS RESEARCH</title><idno type="pISSN">0905-7161</idno><idno type="eISSN">1600-0501</idno><idno type="book-DOI">10.1111/(ISSN)1600-0501</idno><idno type="book-part-DOI">10.1111/clr.2013.24.issue-5</idno><idno type="product">CLR</idno><imprint><biblScope unit="vol">24</biblScope><biblScope unit="issue">5</biblScope><biblScope unit="page" from="592">592</biblScope><biblScope unit="page" to="597">597</biblScope><biblScope unit="page-count">6</biblScope><date type="published" when="2013-05"></date></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><abstract style="main" xml:id="clr2411-abs-0001"><head>Abstract</head>
Objectives
<p>Two fractured one‐piece experimental (commercially unavailable) zirconia implants were analyzed using scanning electron microscope (<hi rend="fc">SEM</hi>) analysis to identify failure origins and aid in understanding the failure mechanisms. Modifications to the zirconia implant design are suggested to minimize such fracture incidences.</p>
Materials and methods
<p>Two zirconia implants fractured during the final torquing in the maxillary ridge using the prescribed hand torque wrench. The implants were subsequently retrieved and prepared for optical and <hi rend="fc">SEM</hi> evaluation. Critical attention was given to the fractography (crack morphology) of the fractured implants to identify the fracture origin.</p>
Results
<p>Events related to initiation and propagation of the crack front could be detected from the morphology of the fractured surfaces. Unfavorable torque and bending forces applied on the implant during surgical placement and the inherent flaws in the material may have resulted in crack initiation and implant failure.</p>
Conclusions
<p>Caution must be exercised when placing zirconia implants in dense bone sites. Modification of surgical protocols for the intended implant site may be necessary. Improvement in design features specific to zirconia implants, and strict quality control during manufacture is essential to minimize the likelihood of fracture.</p></abstract><textClass><keywords rend="articleCategory"><term>Case Report</term></keywords><keywords rend="tocHeading1"><term>Case Report</term></keywords></textClass><langUsage><language ident="en"></language></langUsage></profileDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/62341CCECCBFDB314F9F3BBE2B42E1A3900C005E/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component type="serialArticle" version="2.0" xml:id="clr2411" xml:lang="en"><header><publicationMeta level="product"><doi origin="wiley" registered="yes">10.1111/(ISSN)1600-0501</doi><issn type="print">0905-7161</issn><issn type="electronic">1600-0501</issn><idGroup><id type="product" value="CLR"></id></idGroup><titleGroup><title sort="CLINICAL ORAL IMPLANTS RESEARCH" type="main">Clinical Oral Implants Research</title><title type="short">Clin. Oral Impl. Res.</title></titleGroup></publicationMeta><publicationMeta level="part" position="50"><doi origin="wiley">10.1111/clr.2013.24.issue-5</doi><copyright ownership="publisher">Copyright © 2013 John Wiley & Sons A/S</copyright><numberingGroup><numbering type="journalVolume" number="24">24</numbering><numbering type="journalIssue">5</numbering></numberingGroup><coverDate startDate="2013-05">May 2013</coverDate></publicationMeta><publicationMeta level="unit" position="170" status="forIssue" type="caseStudy"><doi>10.1111/j.1600-0501.2011.02411.x</doi><idGroup><id type="unit" value="CLR2411"></id></idGroup><countGroup><count number="6" type="pageTotal"></count></countGroup><titleGroup><title type="articleCategory">Case Report</title><title type="tocHeading1">Case Report</title></titleGroup><copyright ownership="publisher">© 2012 John Wiley & Sons A/S</copyright><eventGroup><event date="2011-12-12" type="manuscriptAccepted"></event><event agent="SPS" date="2012-01-02" type="xmlCreated"></event><event type="publishedOnlineEarlyUnpaginated" date="2012-01-26"></event><event type="firstOnline" date="2012-01-26"></event><event type="publishedOnlineFinalForm" date="2013-03-25"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:4.0.1" date="2014-03-12"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.6.4 mode:FullText" date="2015-10-03"></event></eventGroup><numberingGroup><numbering type="pageFirst">592</numbering><numbering type="pageLast">597</numbering></numberingGroup><correspondenceTo><lineatedText><line><b>Corresponding author:</b></line><line>Dr Sunyoung Ma</line><line>Sir John Walsh Research Institute</line><line>School of Dentistry, University of Otago</line><line>280 Great King Street</line><line>Dunedin, New Zealand</line><line>Tel.: +64 3 4797044</line><line>Fax: +64 3 479 5079</line><line>e‐mail: <email>sunyoung.ma@otago.ac.nz</email></line></lineatedText></correspondenceTo><selfCitationGroup><citation type="self" xml:id="clr2411-cit-0038">Osman RB, Ma S, Duncan W, De Silva RK, Siddiqi A, Swain MV. Fractured Zirconia Implants and Related Implant Designs: Scanning Electron Microscopy Analysis. <i>Clin. Oral Impl. Res.</i> <b>24</b>, 2013, 592–597</citation></selfCitationGroup><linkGroup><link type="toTypesetVersion" href="file:CLR.CLR2411.pdf"></link></linkGroup></publicationMeta><contentMeta><titleGroup><title type="main">Fractured zirconia implants and related implant designs: scanning electron microscopy analysis</title><title type="shortAuthors">Osman et al.</title></titleGroup><creators><creator affiliationRef="#clr2411-aff-0001" creatorRole="author" xml:id="clr2411-cr-0001"><personName><givenNames>Reham B.</givenNames> <familyName>Osman</familyName></personName></creator><creator affiliationRef="#clr2411-aff-0001" corresponding="yes" creatorRole="author" xml:id="clr2411-cr-0002"><personName><givenNames>Sunyoung</givenNames> <familyName>Ma</familyName></personName></creator><creator affiliationRef="#clr2411-aff-0001" creatorRole="author" xml:id="clr2411-cr-0003"><personName><givenNames>Warwick</givenNames> <familyName>Duncan</familyName></personName></creator><creator affiliationRef="#clr2411-aff-0001" creatorRole="author" xml:id="clr2411-cr-0004"><personName><givenNames>Rohana K.</givenNames> <familyName>De Silva</familyName></personName></creator><creator affiliationRef="#clr2411-aff-0001" creatorRole="author" xml:id="clr2411-cr-0005"><personName><givenNames>Allauddin</givenNames> <familyName>Siddiqi</familyName></personName></creator><creator affiliationRef="#clr2411-aff-0001" creatorRole="author" xml:id="clr2411-cr-0006"><personName><givenNames>Michael V.</givenNames> <familyName>Swain</familyName></personName></creator></creators><affiliationGroup><affiliation countryCode="NZ" type="organization" xml:id="clr2411-aff-0001"><orgDiv>Oral Implantology Research Group</orgDiv> <orgName>Sir John Walsh Research Institute</orgName> <orgDiv>School of Dentistry</orgDiv> <orgName>University of Otago</orgName> <address><city>Dunedin</city> <country>New Zealand</country></address></affiliation></affiliationGroup><fundingInfo><fundingAgency>University of Otago</fundingAgency></fundingInfo><abstractGroup><abstract type="main" xml:id="clr2411-abs-0001"><title type="main">Abstract</title><section xml:id="clr2411-sec-0001"><title type="main">Objectives</title><p>Two fractured one‐piece experimental (commercially unavailable) zirconia implants were analyzed using scanning electron microscope (<fc>SEM</fc>) analysis to identify failure origins and aid in understanding the failure mechanisms. Modifications to the zirconia implant design are suggested to minimize such fracture incidences.</p></section><section xml:id="clr2411-sec-0002"><title type="main">Materials and methods</title><p>Two zirconia implants fractured during the final torquing in the maxillary ridge using the prescribed hand torque wrench. The implants were subsequently retrieved and prepared for optical and <fc>SEM</fc> evaluation. Critical attention was given to the fractography (crack morphology) of the fractured implants to identify the fracture origin.</p></section><section xml:id="clr2411-sec-0003"><title type="main">Results</title><p>Events related to initiation and propagation of the crack front could be detected from the morphology of the fractured surfaces. Unfavorable torque and bending forces applied on the implant during surgical placement and the inherent flaws in the material may have resulted in crack initiation and implant failure.</p></section><section xml:id="clr2411-sec-0004"><title type="main">Conclusions</title><p>Caution must be exercised when placing zirconia implants in dense bone sites. Modification of surgical protocols for the intended implant site may be necessary. Improvement in design features specific to zirconia implants, and strict quality control during manufacture is essential to minimize the likelihood of fracture.</p></section></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Fractured zirconia implants and related implant designs: scanning electron microscopy analysis</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Fractured zirconia implants and related implant designs: scanning electron microscopy analysis</title></titleInfo><name type="personal"><namePart type="given">Reham B.</namePart><namePart type="family">Osman</namePart><affiliation>Oral Implantology Research Group, School of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Sunyoung</namePart><namePart type="family">Ma</namePart><affiliation>Oral Implantology Research Group, School of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand</affiliation><affiliation>Dr Sunyoung MaSir John Walsh Research InstituteSchool of Dentistry, University of Otago280 Great King StreetDunedin, New ZealandTel.: +64 3 4797044Fax: +64 3 479 5079e‐mail:</affiliation><affiliation>E-mail: sunyoung.ma@otago.ac.nz</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Warwick</namePart><namePart type="family">Duncan</namePart><affiliation>Oral Implantology Research Group, School of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Rohana K.</namePart><namePart type="family">De Silva</namePart><affiliation>Oral Implantology Research Group, School of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Allauddin</namePart><namePart type="family">Siddiqi</namePart><affiliation>Oral Implantology Research Group, School of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Michael V.</namePart><namePart type="family">Swain</namePart><affiliation>Oral Implantology Research Group, School of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="case-report" displayLabel="caseStudy" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-29919SZJ-6">case-report</genre><originInfo><publisher>Blackwell Publishing Ltd</publisher><dateIssued encoding="w3cdtf">2013-05</dateIssued><dateCreated encoding="w3cdtf">2012-01-02</dateCreated><dateValid encoding="w3cdtf">2011-12-12</dateValid><edition>Osman RB, Ma S, Duncan W, De Silva RK, Siddiqi A, Swain MV. Fractured Zirconia Implants and Related Implant Designs: Scanning Electron Microscopy Analysis. Clin. Oral Impl. Res. 24, 2013, 592–597</edition><copyrightDate encoding="w3cdtf">2013</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><abstract>Two fractured one‐piece experimental (commercially unavailable) zirconia implants were analyzed using scanning electron microscope (SEM) analysis to identify failure origins and aid in understanding the failure mechanisms. Modifications to the zirconia implant design are suggested to minimize such fracture incidences.</abstract><abstract>Two zirconia implants fractured during the final torquing in the maxillary ridge using the prescribed hand torque wrench. The implants were subsequently retrieved and prepared for optical and SEM evaluation. Critical attention was given to the fractography (crack morphology) of the fractured implants to identify the fracture origin.</abstract><abstract>Events related to initiation and propagation of the crack front could be detected from the morphology of the fractured surfaces. Unfavorable torque and bending forces applied on the implant during surgical placement and the inherent flaws in the material may have resulted in crack initiation and implant failure.</abstract><abstract>Caution must be exercised when placing zirconia implants in dense bone sites. Modification of surgical protocols for the intended implant site may be necessary. Improvement in design features specific to zirconia implants, and strict quality control during manufacture is essential to minimize the likelihood of fracture.</abstract><note type="funding">University of Otago</note><relatedItem type="host"><titleInfo><title>Clinical Oral Implants Research</title></titleInfo><titleInfo type="abbreviated"><title>Clin. 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