Long-term cumulative survival and mechanical complications of single-tooth Ankylos Implants: focus on the abutment neck fractures
Identifieur interne : 006333 ( Ncbi/Merge ); précédent : 006332; suivant : 006334Long-term cumulative survival and mechanical complications of single-tooth Ankylos Implants: focus on the abutment neck fractures
Auteurs : Hye Won Shim [Corée du Sud] ; Byoung-Eun Yang [Corée du Sud]Source :
- The Journal of Advanced Prosthodontics [ 2005-7806 ] ; 2015.
Abstract
To evaluate the cumulative survival rate (CSR) and mechanical complications of single-tooth Ankylos® implants.
This was a retrospective clinical study that analyzed 450 single Ankylos® implants installed in 275 patients between December 2005 and December 2012. The main outcomes were survival results CSR and implant failure) and mechanical complications (screw loosening, fracture, and cumulative fracture rate [CFR]). The main outcomes were analyzed according to age, sex, implant length or diameter, bone graft, arch, and position.
The 8-year CSR was 96.9%. Thirteen (2.9%) implants failed because of early osseointegration failure in 3, marginal bone loss in 6, and abutment fracture in 4. Screw loosening occurred in 10 implants (2.2%), and 10 abutment fractures occurred. All abutment fractures were located in the neck, and concurrent screw fractures were observed. The CSR and rate of screw loosening did not differ significantly according to factors. The CFR was higher in middle-aged patients (5.3% vs 0.0% in younger and older patients); for teeth in a molar position (5.8% vs 0.0% for premolar or 1.1% for anterior position); and for larger-diameter implants (4.5% for 4.5 mm and 6.7% for 5.5 mm diameter vs 0.5% for 3.5 mm diameter) (all P<.05).
The Ankylos® implant is suitable for single-tooth restoration in Koreans. However, relatively frequent abutment fractures (2.2%) were observed and some fractures resulted in implant failures. Middle-aged patients, the molar position, and a large implant diameter were associated with a high incidence of abutment fracture.
Url:
DOI: 10.4047/jap.2015.7.6.423
PubMed: 26813443
PubMed Central: 4722145
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<author><name sortKey="Shim, Hye Won" sort="Shim, Hye Won" uniqKey="Shim H" first="Hye Won" last="Shim">Hye Won Shim</name>
<affiliation wicri:level="1"><nlm:aff id="A1">Department of Prosthodontics, Hallym University School of Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea.</nlm:aff>
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<author><name sortKey="Yang, Byoung Eun" sort="Yang, Byoung Eun" uniqKey="Yang B" first="Byoung-Eun" last="Yang">Byoung-Eun Yang</name>
<affiliation wicri:level="1"><nlm:aff id="A2">Department of Oral and Maxillofacial Surgery, Hallym University School of Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea.</nlm:aff>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Long-term cumulative survival and mechanical complications of single-tooth Ankylos Implants: focus on the abutment neck fractures</title>
<author><name sortKey="Shim, Hye Won" sort="Shim, Hye Won" uniqKey="Shim H" first="Hye Won" last="Shim">Hye Won Shim</name>
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<author><name sortKey="Yang, Byoung Eun" sort="Yang, Byoung Eun" uniqKey="Yang B" first="Byoung-Eun" last="Yang">Byoung-Eun Yang</name>
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<series><title level="j">The Journal of Advanced Prosthodontics</title>
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<front><div type="abstract" xml:lang="en"><sec><title>PURPOSE</title>
<p>To evaluate the cumulative survival rate (CSR) and mechanical complications of single-tooth Ankylos® implants.</p>
</sec>
<sec><title>MATERIALS AND METHODS</title>
<p>This was a retrospective clinical study that analyzed 450 single Ankylos® implants installed in 275 patients between December 2005 and December 2012. The main outcomes were survival results CSR and implant failure) and mechanical complications (screw loosening, fracture, and cumulative fracture rate [CFR]). The main outcomes were analyzed according to age, sex, implant length or diameter, bone graft, arch, and position.</p>
</sec>
<sec><title>RESULTS</title>
<p>The 8-year CSR was 96.9%. Thirteen (2.9%) implants failed because of early osseointegration failure in 3, marginal bone loss in 6, and abutment fracture in 4. Screw loosening occurred in 10 implants (2.2%), and 10 abutment fractures occurred. All abutment fractures were located in the neck, and concurrent screw fractures were observed. The CSR and rate of screw loosening did not differ significantly according to factors. The CFR was higher in middle-aged patients (5.3% vs 0.0% in younger and older patients); for teeth in a molar position (5.8% vs 0.0% for premolar or 1.1% for anterior position); and for larger-diameter implants (4.5% for 4.5 mm and 6.7% for 5.5 mm diameter vs 0.5% for 3.5 mm diameter) (all P<.05).</p>
</sec>
<sec><title>CONCLUSION</title>
<p>The Ankylos® implant is suitable for single-tooth restoration in Koreans. However, relatively frequent abutment fractures (2.2%) were observed and some fractures resulted in implant failures. Middle-aged patients, the molar position, and a large implant diameter were associated with a high incidence of abutment fracture.</p>
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<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Adv Prosthodont</journal-id>
<journal-id journal-id-type="iso-abbrev">J Adv Prosthodont</journal-id>
<journal-id journal-id-type="publisher-id">JAP</journal-id>
<journal-title-group><journal-title>The Journal of Advanced Prosthodontics</journal-title>
</journal-title-group>
<issn pub-type="ppub">2005-7806</issn>
<issn pub-type="epub">2005-7814</issn>
<publisher><publisher-name>The Korean Academy of Prosthodontics</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">26813443</article-id>
<article-id pub-id-type="pmc">4722145</article-id>
<article-id pub-id-type="doi">10.4047/jap.2015.7.6.423</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Original Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Long-term cumulative survival and mechanical complications of single-tooth Ankylos Implants: focus on the abutment neck fractures</article-title>
</title-group>
<contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid" authenticated="false">http://orcid.org/0000-0002-3035-0963</contrib-id>
<name><surname>Shim</surname>
<given-names>Hye Won</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="false">http://orcid.org/0000-0002-4446-6772</contrib-id>
<name><surname>Yang</surname>
<given-names>Byoung-Eun</given-names>
</name>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
</contrib-group>
<aff id="A1"><label>1</label>
Department of Prosthodontics, Hallym University School of Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea.</aff>
<aff id="A2"><label>2</label>
Department of Oral and Maxillofacial Surgery, Hallym University School of Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea.</aff>
<author-notes><corresp>Corresponding author: Hye Won Shim. Department of Prosthodontics, Hallym University School of Medicine, Hallym University Sacred Heart Hospital 22, Gwanpyeong-ro 170-gil (896, Pyeongchon-dong), Dongan-gu, Anyang, Gyeonggi-do, 14068, Republic of Korea. Tel. 82 31 380 5974: <email>hyewonshim@hallym.or.kr</email>
</corresp>
</author-notes>
<pub-date pub-type="ppub"><month>12</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="epub"><day>30</day>
<month>12</month>
<year>2015</year>
</pub-date>
<volume>7</volume>
<issue>6</issue>
<fpage>423</fpage>
<lpage>430</lpage>
<history><date date-type="received"><day>14</day>
<month>1</month>
<year>2015</year>
</date>
<date date-type="rev-recd"><day>25</day>
<month>3</month>
<year>2015</year>
</date>
<date date-type="accepted"><day>11</day>
<month>5</month>
<year>2015</year>
</date>
</history>
<permissions><copyright-statement>© 2015 The Korean Academy of Prosthodontics</copyright-statement>
<copyright-year>2015</copyright-year>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/">http://creativecommons.org/licenses/by-nc/3.0/</ext-link>
) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<abstract><sec><title>PURPOSE</title>
<p>To evaluate the cumulative survival rate (CSR) and mechanical complications of single-tooth Ankylos® implants.</p>
</sec>
<sec><title>MATERIALS AND METHODS</title>
<p>This was a retrospective clinical study that analyzed 450 single Ankylos® implants installed in 275 patients between December 2005 and December 2012. The main outcomes were survival results CSR and implant failure) and mechanical complications (screw loosening, fracture, and cumulative fracture rate [CFR]). The main outcomes were analyzed according to age, sex, implant length or diameter, bone graft, arch, and position.</p>
</sec>
<sec><title>RESULTS</title>
<p>The 8-year CSR was 96.9%. Thirteen (2.9%) implants failed because of early osseointegration failure in 3, marginal bone loss in 6, and abutment fracture in 4. Screw loosening occurred in 10 implants (2.2%), and 10 abutment fractures occurred. All abutment fractures were located in the neck, and concurrent screw fractures were observed. The CSR and rate of screw loosening did not differ significantly according to factors. The CFR was higher in middle-aged patients (5.3% vs 0.0% in younger and older patients); for teeth in a molar position (5.8% vs 0.0% for premolar or 1.1% for anterior position); and for larger-diameter implants (4.5% for 4.5 mm and 6.7% for 5.5 mm diameter vs 0.5% for 3.5 mm diameter) (all P<.05).</p>
</sec>
<sec><title>CONCLUSION</title>
<p>The Ankylos® implant is suitable for single-tooth restoration in Koreans. However, relatively frequent abutment fractures (2.2%) were observed and some fractures resulted in implant failures. Middle-aged patients, the molar position, and a large implant diameter were associated with a high incidence of abutment fracture.</p>
</sec>
</abstract>
<kwd-group><kwd>Osseointegration</kwd>
<kwd>Dental implants</kwd>
<kwd>Single-tooth</kwd>
<kwd>Dental implant-abutment design</kwd>
<kwd>Periprosthetic fractures</kwd>
</kwd-group>
</article-meta>
</front>
<floats-group><fig id="F1" orientation="portrait" position="float"><label>Fig. 1</label>
<caption><title>Ankylos implant system (A) and its radiologic view (B).</title>
</caption>
<graphic xlink:href="jap-7-423-g001"></graphic>
</fig>
<fig id="F2" orientation="portrait" position="float"><label>Fig. 2</label>
<caption><title>Intra-oral view of abutment neck fracture (A) and fractured abutment (B).</title>
</caption>
<graphic xlink:href="jap-7-423-g002"></graphic>
</fig>
<table-wrap id="T1" orientation="portrait" position="float"><label>Table 1</label>
<caption><title>Baseline data and 8-years cumulative survival rate (CSR) of gender, age, bone graft, length of implant, position, jawbone and type of diameter in single-tooth Ankylos implants (n = 450)</title>
</caption>
<alternatives><graphic xlink:href="jap-7-423-i001"></graphic>
<table frame="hsides" rules="rows"><thead><tr><th valign="top" align="left" rowspan="1" colspan="1"></th>
<th valign="top" rowspan="1" colspan="1"></th>
<th valign="top" align="center" rowspan="1" colspan="1">No.</th>
<th valign="top" align="center" rowspan="1" colspan="1">8 years CSR</th>
<th valign="top" align="center" rowspan="1" colspan="1"><italic>P</italic>
value<sup>*</sup>
</th>
</tr>
</thead>
<tbody><tr><td valign="middle" align="left" rowspan="2" colspan="1">Gender</td>
<td valign="middle" align="left" rowspan="1" colspan="1">Male</td>
<td valign="middle" align="right" rowspan="1" colspan="1">251 (55.8)</td>
<td valign="middle" align="right" rowspan="1" colspan="1">95.9%</td>
<td valign="top" align="right" rowspan="2" colspan="1">.136</td>
</tr>
<tr><td valign="top" align="left" rowspan="1" colspan="1">Female</td>
<td valign="top" align="right" rowspan="1" colspan="1">199 (44.2)</td>
<td valign="top" align="right" rowspan="1" colspan="1">98.2%</td>
</tr>
<tr><td valign="top" align="left" rowspan="3" colspan="1">Age</td>
<td valign="top" align="left" rowspan="1" colspan="1">Young (15 - 39 years)</td>
<td valign="top" align="right" rowspan="1" colspan="1">94 (20.9)</td>
<td valign="top" align="right" rowspan="1" colspan="1">100%</td>
<td valign="top" align="right" rowspan="3" colspan="1">.060</td>
</tr>
<tr><td valign="top" align="left" rowspan="1" colspan="1">Middle (40 - 65 years)</td>
<td valign="top" align="right" rowspan="1" colspan="1">278 (61.8)</td>
<td valign="top" align="right" rowspan="1" colspan="1">95.3%</td>
</tr>
<tr><td valign="top" align="left" rowspan="1" colspan="1">Old (> 65 years)</td>
<td valign="top" align="right" rowspan="1" colspan="1">78 (17.3)</td>
<td valign="top" align="right" rowspan="1" colspan="1">98.7%</td>
</tr>
<tr><td valign="top" align="left" rowspan="4" colspan="1">Length</td>
<td valign="top" align="left" rowspan="1" colspan="1">8 mm</td>
<td valign="top" align="right" rowspan="1" colspan="1">82 (18.2)</td>
<td valign="top" align="right" rowspan="1" colspan="1">95.1%</td>
<td valign="top" align="right" rowspan="4" colspan="1">.591</td>
</tr>
<tr><td valign="top" align="left" rowspan="1" colspan="1">9.5 mm</td>
<td valign="top" align="right" rowspan="1" colspan="1">150 (33.3)</td>
<td valign="top" align="right" rowspan="1" colspan="1">96.9%</td>
</tr>
<tr><td valign="top" align="left" rowspan="1" colspan="1">11 mm</td>
<td valign="top" align="right" rowspan="1" colspan="1">193 (42.9)</td>
<td valign="top" align="right" rowspan="1" colspan="1">97.4%</td>
</tr>
<tr><td valign="top" align="left" rowspan="1" colspan="1">14 mm</td>
<td valign="top" align="right" rowspan="1" colspan="1">25 (5.6)</td>
<td valign="top" align="right" rowspan="1" colspan="1">100%</td>
</tr>
<tr><td valign="top" align="left" rowspan="3" colspan="1">Type of diameter</td>
<td valign="top" align="left" rowspan="1" colspan="1">3.5 mm</td>
<td valign="top" align="right" rowspan="1" colspan="1">200 (44.4)</td>
<td valign="top" align="right" rowspan="1" colspan="1">97.4%</td>
<td valign="top" align="right" rowspan="3" colspan="1">.954</td>
</tr>
<tr><td valign="top" align="left" rowspan="1" colspan="1">4.5 mm</td>
<td valign="top" align="right" rowspan="1" colspan="1">219 (48.7)</td>
<td valign="top" align="right" rowspan="1" colspan="1">96.7%</td>
</tr>
<tr><td valign="top" align="left" rowspan="1" colspan="1">5.5 mm</td>
<td valign="top" align="right" rowspan="1" colspan="1">31 (6.9)</td>
<td valign="top" align="right" rowspan="1" colspan="1">96.6%</td>
</tr>
<tr><td valign="top" align="left" rowspan="3" colspan="1">Position</td>
<td valign="top" align="left" rowspan="1" colspan="1">Anterior</td>
<td valign="top" align="right" rowspan="1" colspan="1">100 (22.2)</td>
<td valign="top" align="right" rowspan="1" colspan="1">97.0%</td>
<td valign="top" align="right" rowspan="3" colspan="1">.230</td>
</tr>
<tr><td valign="top" align="left" rowspan="1" colspan="1">Premolar</td>
<td valign="top" align="right" rowspan="1" colspan="1">130 (28.9)</td>
<td valign="top" align="right" rowspan="1" colspan="1">99.2%</td>
</tr>
<tr><td valign="top" align="left" rowspan="1" colspan="1">Molar</td>
<td valign="top" align="right" rowspan="1" colspan="1">220 (48.9)</td>
<td valign="top" align="right" rowspan="1" colspan="1">95.7%</td>
</tr>
<tr><td valign="top" align="left" rowspan="2" colspan="1">Jawbone</td>
<td valign="top" align="left" rowspan="1" colspan="1">Mandible</td>
<td valign="top" align="right" rowspan="1" colspan="1">197 (43.8)</td>
<td valign="top" align="right" rowspan="1" colspan="1">98.2%</td>
<td valign="top" align="right" rowspan="2" colspan="1">.109</td>
</tr>
<tr><td valign="top" align="left" rowspan="1" colspan="1">Maxillary</td>
<td valign="top" align="right" rowspan="1" colspan="1">253 (56.2)</td>
<td valign="top" align="right" rowspan="1" colspan="1">95.9%</td>
</tr>
<tr><td valign="top" align="left" rowspan="2" colspan="1">Bone graft</td>
<td valign="top" align="left" rowspan="1" colspan="1">Yes</td>
<td valign="top" align="right" rowspan="1" colspan="1">123 (27.3)</td>
<td valign="top" align="right" rowspan="1" colspan="1">95.1%</td>
<td valign="top" align="right" rowspan="10" colspan="1">.130</td>
</tr>
<tr><td valign="top" align="left" rowspan="1" colspan="1">No</td>
<td valign="top" align="right" rowspan="1" colspan="1">327 (72.7)</td>
<td valign="top" align="right" rowspan="1" colspan="1">97.6%</td>
</tr>
<tr><td valign="top" align="left" rowspan="8" colspan="1">Loading periods, months</td>
<td valign="top" align="left" rowspan="1" colspan="1">≤ 2 years</td>
<td valign="top" align="right" rowspan="1" colspan="1">14 (3.1)</td>
<td valign="top" align="right" rowspan="1" colspan="1"></td>
</tr>
<tr><td valign="top" align="left" rowspan="1" colspan="1">2-3 years</td>
<td valign="top" align="right" rowspan="1" colspan="1">4 (0.9)</td>
<td valign="top" align="right" rowspan="1" colspan="1"></td>
</tr>
<tr><td valign="top" align="left" rowspan="1" colspan="1">3-4 years</td>
<td valign="top" align="right" rowspan="1" colspan="1">51 (11.3)</td>
<td valign="top" align="right" rowspan="1" colspan="1"></td>
</tr>
<tr><td valign="top" align="left" rowspan="1" colspan="1">4-5 years</td>
<td valign="top" align="right" rowspan="1" colspan="1">109 (24.2)</td>
<td valign="top" align="right" rowspan="1" colspan="1"></td>
</tr>
<tr><td valign="top" align="left" rowspan="1" colspan="1">5-6 years</td>
<td valign="top" align="right" rowspan="1" colspan="1">135 (30.0)</td>
<td valign="top" align="right" rowspan="1" colspan="1"></td>
</tr>
<tr><td valign="top" align="left" rowspan="1" colspan="1">6-7 years</td>
<td valign="top" align="right" rowspan="1" colspan="1">101 (22.4)</td>
<td valign="top" align="right" rowspan="1" colspan="1"></td>
</tr>
<tr><td valign="top" align="left" rowspan="1" colspan="1">7-8 years</td>
<td valign="top" align="right" rowspan="1" colspan="1">33 (7.3)</td>
<td valign="top" align="right" rowspan="1" colspan="1"></td>
</tr>
<tr><td valign="top" align="left" rowspan="1" colspan="1">> 8 years</td>
<td valign="top" align="right" rowspan="1" colspan="1">3 (0.7)</td>
<td valign="top" align="right" rowspan="1" colspan="1"></td>
</tr>
</tbody>
</table>
</alternatives>
<table-wrap-foot><fn><p><sup>*</sup>
Estimated Cumulative rate and P-value from Kaplan-Meier analysis with Log-Rank test.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="T2" orientation="portrait" position="float"><label>Table 2</label>
<caption><title>Comparison of screw loosening, fracture and cumulative fracture rate (CFR) in gender, age, bone graft, length of implant, position, jawbone and type of diameter</title>
</caption>
<alternatives><graphic xlink:href="jap-7-423-i002"></graphic>
<table frame="hsides" rules="rows"><thead><tr><th valign="top" align="center" rowspan="2" colspan="1"></th>
<th valign="top" align="center" rowspan="2" colspan="1"></th>
<th valign="top" align="center" rowspan="1" colspan="2">Screw loosening (n = 10)</th>
<th valign="top" align="center" rowspan="1" colspan="4">Fracture (n = 10)</th>
</tr>
<tr><th valign="top" align="center" rowspan="1" colspan="1">No (%)</th>
<th valign="top" align="center" rowspan="1" colspan="1"><italic>P</italic>
value<sup>*</sup>
</th>
<th valign="top" align="center" rowspan="1" colspan="1">No (%)</th>
<th valign="top" align="center" rowspan="1" colspan="1">5yr CFR</th>
<th valign="top" align="center" rowspan="1" colspan="1">8yr CFR</th>
<th valign="top" align="center" rowspan="1" colspan="1"><italic>P</italic>
value<sup>†</sup>
</th>
</tr>
</thead>
<tbody><tr><td valign="middle" align="left" rowspan="2" colspan="1">Gender</td>
<td valign="middle" align="left" rowspan="1" colspan="1">Male</td>
<td valign="top" align="right" rowspan="1" colspan="1">7/251 (2.8)</td>
<td valign="top" align="center" rowspan="2" colspan="1">.360</td>
<td valign="top" align="right" rowspan="1" colspan="1">8/251 (3.2)</td>
<td valign="top" align="center" rowspan="1" colspan="1">2.50%</td>
<td valign="top" align="center" rowspan="1" colspan="1">4.20%</td>
<td valign="top" align="center" rowspan="2" colspan="1">.159</td>
</tr>
<tr><td valign="top" align="left" rowspan="1" colspan="1">Female</td>
<td valign="top" align="right" rowspan="1" colspan="1">3/199 (1.5)</td>
<td valign="top" align="right" rowspan="1" colspan="1">2/199 (1.0)</td>
<td valign="top" align="center" rowspan="1" colspan="1">1.00%</td>
<td valign="top" align="center" rowspan="1" colspan="1">1.00%</td>
</tr>
<tr><td valign="top" align="left" rowspan="3" colspan="1">Age</td>
<td valign="top" align="left" rowspan="1" colspan="1">Young (15 - 39 years)</td>
<td valign="top" align="right" rowspan="1" colspan="1">4/94 (4.3)</td>
<td valign="top" align="center" rowspan="3" colspan="1">.311</td>
<td valign="top" align="right" rowspan="1" colspan="1">0/94 (0.0)</td>
<td valign="top" align="center" rowspan="1" colspan="1">0.00%</td>
<td valign="top" align="center" rowspan="1" colspan="1">0.00%</td>
<td valign="top" align="center" rowspan="3" colspan="1">.031</td>
</tr>
<tr><td valign="top" align="left" rowspan="1" colspan="1">Middle (40 - 65 years)</td>
<td valign="top" align="right" rowspan="1" colspan="1">5/278 (1.8)</td>
<td valign="top" align="right" rowspan="1" colspan="1">10/278 (3.6)</td>
<td valign="top" align="center" rowspan="1" colspan="1">3.10%</td>
<td valign="top" align="center" rowspan="1" colspan="1">5.30%</td>
</tr>
<tr><td valign="top" align="left" rowspan="1" colspan="1">Old (> 65 years)</td>
<td valign="top" align="right" rowspan="1" colspan="1">1/78 (1.3)</td>
<td valign="top" align="right" rowspan="1" colspan="1">0/78 (0.0)</td>
<td valign="top" align="center" rowspan="1" colspan="1">0.00%</td>
<td valign="top" align="center" rowspan="1" colspan="1">0.00%</td>
</tr>
<tr><td valign="top" align="left" rowspan="4" colspan="1">Length</td>
<td valign="top" align="left" rowspan="1" colspan="1">8 mm</td>
<td valign="top" align="right" rowspan="1" colspan="1">2/82 (2.4)</td>
<td valign="top" align="center" rowspan="4" colspan="1">.864</td>
<td valign="top" align="right" rowspan="1" colspan="1">3/82 (3.7)</td>
<td valign="top" align="center" rowspan="1" colspan="1">3.70%</td>
<td valign="top" align="center" rowspan="1" colspan="1">3.70%</td>
<td valign="top" align="center" rowspan="4" colspan="1">.538</td>
</tr>
<tr><td valign="top" align="left" rowspan="1" colspan="1">9.5 mm</td>
<td valign="top" align="right" rowspan="1" colspan="1">3/150 (2.0)</td>
<td valign="top" align="right" rowspan="1" colspan="1">2/150 (1.3)</td>
<td valign="top" align="center" rowspan="1" colspan="1">0.80%</td>
<td valign="top" align="center" rowspan="1" colspan="1">3.70%</td>
</tr>
<tr><td valign="top" align="left" rowspan="1" colspan="1">11 mm</td>
<td valign="top" align="right" rowspan="1" colspan="1">5/195 (2.6)</td>
<td valign="top" align="right" rowspan="1" colspan="1">4/195 (2.1)</td>
<td valign="top" align="center" rowspan="1" colspan="1">1.60%</td>
<td valign="top" align="center" rowspan="1" colspan="1">2.80%</td>
</tr>
<tr><td valign="top" align="left" rowspan="1" colspan="1">14 mm</td>
<td valign="top" align="right" rowspan="1" colspan="1">0/25 (0.0)</td>
<td valign="top" align="right" rowspan="1" colspan="1">1/25 (4.0)</td>
<td valign="top" align="center" rowspan="1" colspan="1">4.20%</td>
<td valign="top" align="center" rowspan="1" colspan="1">4.20%</td>
</tr>
<tr><td valign="top" align="left" rowspan="3" colspan="1">Type of diameter</td>
<td valign="top" align="left" rowspan="1" colspan="1">3.5 mm</td>
<td valign="top" align="right" rowspan="1" colspan="1">4/200 (2.0)</td>
<td valign="top" align="center" rowspan="3" colspan="1">.908</td>
<td valign="top" align="right" rowspan="1" colspan="1">1/200 (0.5)</td>
<td valign="top" align="center" rowspan="1" colspan="1">0.50%</td>
<td valign="top" align="center" rowspan="1" colspan="1">0.50%</td>
<td valign="top" align="center" rowspan="3" colspan="1">.044<sup>‡</sup>
</td>
</tr>
<tr><td valign="top" align="left" rowspan="1" colspan="1">4.5 mm</td>
<td valign="top" align="right" rowspan="1" colspan="1">5/218 (2.3)</td>
<td valign="top" align="right" rowspan="1" colspan="1">7/218 (3.2)</td>
<td valign="top" align="center" rowspan="1" colspan="1">2.30%</td>
<td valign="top" align="center" rowspan="1" colspan="1">4.50%</td>
</tr>
<tr><td valign="top" align="left" rowspan="1" colspan="1">5.5 mm</td>
<td valign="top" align="right" rowspan="1" colspan="1">1/32 (3.2)</td>
<td valign="top" align="right" rowspan="1" colspan="1">2/32 (6.5)</td>
<td valign="top" align="center" rowspan="1" colspan="1">6.70%</td>
<td valign="top" align="center" rowspan="1" colspan="1">6.70%</td>
</tr>
<tr><td valign="top" align="left" rowspan="5" colspan="1">Position</td>
<td valign="top" align="left" rowspan="1" colspan="1">Anterior</td>
<td valign="top" align="right" rowspan="1" colspan="1">2/100 (2.0)</td>
<td valign="top" align="center" rowspan="3" colspan="1">.330</td>
<td valign="top" align="right" rowspan="1" colspan="1">1/100 (1.0)</td>
<td valign="top" align="center" rowspan="1" colspan="1">1.10%</td>
<td valign="top" align="center" rowspan="1" colspan="1">1.10%</td>
<td valign="top" align="center" rowspan="3" colspan="1">.027</td>
</tr>
<tr><td valign="top" align="left" rowspan="1" colspan="1">Premolar</td>
<td valign="top" align="right" rowspan="1" colspan="1">1/130 (0.8)</td>
<td valign="top" align="right" rowspan="1" colspan="1">0/130 (0.0)</td>
<td valign="top" align="center" rowspan="1" colspan="1">0.00%</td>
<td valign="top" align="center" rowspan="1" colspan="1">0.00%</td>
</tr>
<tr><td valign="top" align="left" rowspan="1" colspan="1">Molar</td>
<td valign="top" align="right" rowspan="1" colspan="1">7/220 (3.2)</td>
<td valign="top" align="right" rowspan="1" colspan="1">9/220 (4.1)</td>
<td valign="top" align="center" rowspan="1" colspan="1">3.30%</td>
<td valign="top" align="center" rowspan="1" colspan="1">5.80%</td>
</tr>
<tr><td valign="top" align="left" rowspan="1" colspan="1">Mandible</td>
<td valign="top" align="right" rowspan="1" colspan="1">3/197 (1.5)</td>
<td valign="top" align="center" rowspan="2" colspan="1">.524</td>
<td valign="top" align="right" rowspan="1" colspan="1">5/197 (2.5)</td>
<td valign="top" align="center" rowspan="1" colspan="1">2.10%</td>
<td valign="top" align="center" rowspan="1" colspan="1">3.50%</td>
<td valign="top" align="center" rowspan="2" colspan="1">.716</td>
</tr>
<tr><td valign="top" align="left" rowspan="1" colspan="1">Maxillary</td>
<td valign="top" align="right" rowspan="1" colspan="1">7/253 (2.8)</td>
<td valign="top" align="right" rowspan="1" colspan="1">5/253 (2.0)</td>
<td valign="top" align="center" rowspan="1" colspan="1">1.70%</td>
<td valign="top" align="center" rowspan="1" colspan="1">2.80%</td>
</tr>
<tr><td valign="top" align="left" rowspan="2" colspan="1">Bone graft</td>
<td valign="top" align="left" rowspan="1" colspan="1">Yes</td>
<td valign="top" align="right" rowspan="1" colspan="1">4/121 (1.8)</td>
<td valign="top" align="center" rowspan="2" colspan="1">.472</td>
<td valign="top" align="right" rowspan="1" colspan="1">2/121 (1.6)</td>
<td valign="top" align="center" rowspan="1" colspan="1">1.70%</td>
<td valign="top" align="center" rowspan="1" colspan="1">1.70%</td>
<td valign="top" align="center" rowspan="2" colspan="1">.684</td>
</tr>
<tr><td valign="top" align="left" rowspan="1" colspan="1">No</td>
<td valign="top" align="right" rowspan="1" colspan="1">6/327 (3.3)</td>
<td valign="top" align="right" rowspan="1" colspan="1">8/327 (2.4)</td>
<td valign="top" align="center" rowspan="1" colspan="1">2.00%</td>
<td valign="top" align="center" rowspan="1" colspan="1">3.30%</td>
</tr>
</tbody>
</table>
</alternatives>
<table-wrap-foot><fn><p><sup>*</sup>
a chi-square test or a Mann-Whitney rank sum test</p>
<p><sup>†</sup>
Estimated Cumulative rate and <italic>P</italic>
value from Kaplan-Meier analysis with Log-Rank test</p>
<p><sup>‡</sup>
In post-hoc analysis, only <italic>P</italic>
value <.05 in 3.5 mm diameter vs 4.5 mm or 5.5 mm diameter, and there were no significant difference between 4.5 mm diameter and 5.5 mm diameter (<italic>P</italic>
=.296)</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="T3" orientation="portrait" position="float"><label>Table 3</label>
<caption><title>Data of 10 significant mechanical fractures</title>
</caption>
<alternatives><graphic xlink:href="jap-7-423-i003"></graphic>
<table frame="hsides" rules="rows"><thead><tr><th valign="middle" align="center" rowspan="1" colspan="1"></th>
<th valign="middle" align="center" rowspan="1" colspan="1">Gender</th>
<th valign="middle" align="center" rowspan="1" colspan="1">Age</th>
<th valign="middle" align="center" rowspan="1" colspan="1">Position</th>
<th valign="middle" align="center" rowspan="1" colspan="1">Bone graft</th>
<th valign="middle" align="center" rowspan="1" colspan="1">Implant length</th>
<th valign="middle" align="center" rowspan="1" colspan="1">Diameter</th>
<th valign="middle" align="center" rowspan="1" colspan="1">Preceding screw loosening</th>
<th valign="middle" align="center" rowspan="1" colspan="1">Fracture site</th>
<th valign="middle" align="center" rowspan="1" colspan="1">Re-restoration</th>
<th valign="middle" align="center" rowspan="1" colspan="1">Periods (months)</th>
<th valign="middle" align="center" rowspan="1" colspan="1">Para-functional habit or dental status</th>
</tr>
</thead>
<tbody><tr><td valign="top" align="center" rowspan="1" colspan="1">1</td>
<td valign="top" align="center" rowspan="1" colspan="1">Female</td>
<td valign="top" align="center" rowspan="1" colspan="1">54</td>
<td valign="top" align="center" rowspan="1" colspan="1">37</td>
<td valign="top" align="center" rowspan="1" colspan="1">No</td>
<td valign="top" align="right" rowspan="1" colspan="1">8 mm</td>
<td valign="top" align="right" rowspan="1" colspan="1">4.5 mm</td>
<td valign="top" align="center" rowspan="1" colspan="1">No</td>
<td valign="top" align="center" rowspan="1" colspan="1">Abutment neck with screw</td>
<td valign="top" align="center" rowspan="1" colspan="1">Yes</td>
<td valign="top" align="center" rowspan="1" colspan="1">20</td>
<td valign="top" align="center" rowspan="1" colspan="1">Attrition</td>
</tr>
<tr><td valign="top" align="center" rowspan="1" colspan="1">2</td>
<td valign="top" align="center" rowspan="1" colspan="1">Female</td>
<td valign="top" align="center" rowspan="1" colspan="1">48</td>
<td valign="top" align="center" rowspan="1" colspan="1">46</td>
<td valign="top" align="center" rowspan="1" colspan="1">No</td>
<td valign="top" align="right" rowspan="1" colspan="1">8 mm</td>
<td valign="top" align="right" rowspan="1" colspan="1">5.5 mm</td>
<td valign="top" align="center" rowspan="1" colspan="1">Yes</td>
<td valign="top" align="center" rowspan="1" colspan="1">Abutment neck with screw</td>
<td valign="top" align="center" rowspan="1" colspan="1">Yes</td>
<td valign="top" align="center" rowspan="1" colspan="1">26</td>
<td valign="top" align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td valign="top" align="center" rowspan="1" colspan="1">3</td>
<td valign="top" align="center" rowspan="1" colspan="1">Male</td>
<td valign="top" align="center" rowspan="1" colspan="1">49</td>
<td valign="top" align="center" rowspan="1" colspan="1">46</td>
<td valign="top" align="center" rowspan="1" colspan="1">No</td>
<td valign="top" align="right" rowspan="1" colspan="1">11 mm</td>
<td valign="top" align="right" rowspan="1" colspan="1">4.5 mm</td>
<td valign="top" align="center" rowspan="1" colspan="1">Yes</td>
<td valign="top" align="center" rowspan="1" colspan="1">Abutment neck with screw</td>
<td valign="top" align="center" rowspan="1" colspan="1">No</td>
<td valign="top" align="center" rowspan="1" colspan="1">29</td>
<td valign="top" align="center" rowspan="1" colspan="1">Attrition</td>
</tr>
<tr><td valign="top" align="center" rowspan="1" colspan="1">4</td>
<td valign="top" align="center" rowspan="1" colspan="1">Male</td>
<td valign="top" align="center" rowspan="1" colspan="1">47</td>
<td valign="top" align="center" rowspan="1" colspan="1">12</td>
<td valign="top" align="center" rowspan="1" colspan="1">No</td>
<td valign="top" align="right" rowspan="1" colspan="1">11 mm</td>
<td valign="top" align="right" rowspan="1" colspan="1">3.5 mm</td>
<td valign="top" align="center" rowspan="1" colspan="1">Yes</td>
<td valign="top" align="center" rowspan="1" colspan="1">Abutment neck with screw, Porceline</td>
<td valign="top" align="center" rowspan="1" colspan="1">Yes</td>
<td valign="top" align="center" rowspan="1" colspan="1">32</td>
<td valign="top" align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td valign="top" align="center" rowspan="1" colspan="1">5</td>
<td valign="top" align="center" rowspan="1" colspan="1">Male</td>
<td valign="top" align="center" rowspan="1" colspan="1">58</td>
<td valign="top" align="center" rowspan="1" colspan="1">17</td>
<td valign="top" align="center" rowspan="1" colspan="1">Yes</td>
<td valign="top" align="right" rowspan="1" colspan="1">8 mm</td>
<td valign="top" align="right" rowspan="1" colspan="1">4.5 mm</td>
<td valign="top" align="center" rowspan="1" colspan="1">No</td>
<td valign="top" align="center" rowspan="1" colspan="1">Abutment neck with screw</td>
<td valign="top" align="center" rowspan="1" colspan="1">No</td>
<td valign="top" align="center" rowspan="1" colspan="1">33</td>
<td valign="top" align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td valign="top" align="center" rowspan="1" colspan="1">6</td>
<td valign="top" align="center" rowspan="1" colspan="1">Male</td>
<td valign="top" align="center" rowspan="1" colspan="1">49</td>
<td valign="top" align="center" rowspan="1" colspan="1">26</td>
<td valign="top" align="center" rowspan="1" colspan="1">Yes</td>
<td valign="top" align="right" rowspan="1" colspan="1">11 mm</td>
<td valign="top" align="right" rowspan="1" colspan="1">4.5 mm</td>
<td valign="top" align="center" rowspan="1" colspan="1">No</td>
<td valign="top" align="center" rowspan="1" colspan="1">Abutment neck with screw</td>
<td valign="top" align="center" rowspan="1" colspan="1">No</td>
<td valign="top" align="center" rowspan="1" colspan="1">38</td>
<td valign="top" align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td valign="top" align="center" rowspan="1" colspan="1">7</td>
<td valign="top" align="center" rowspan="1" colspan="1">Male</td>
<td valign="top" align="center" rowspan="1" colspan="1">47</td>
<td valign="top" align="center" rowspan="1" colspan="1">47</td>
<td valign="top" align="center" rowspan="1" colspan="1">No</td>
<td valign="top" align="right" rowspan="1" colspan="1">9.5 mm</td>
<td valign="top" align="right" rowspan="1" colspan="1">5.5 mm</td>
<td valign="top" align="center" rowspan="1" colspan="1">No</td>
<td valign="top" align="center" rowspan="1" colspan="1">Abutment neck with screw</td>
<td valign="top" align="center" rowspan="1" colspan="1">No</td>
<td valign="top" align="center" rowspan="1" colspan="1">51</td>
<td valign="top" align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td valign="top" align="center" rowspan="1" colspan="1">8</td>
<td valign="top" align="center" rowspan="1" colspan="1">Male</td>
<td valign="top" align="center" rowspan="1" colspan="1">56</td>
<td valign="top" align="center" rowspan="1" colspan="1">37</td>
<td valign="top" align="center" rowspan="1" colspan="1">No</td>
<td valign="top" align="right" rowspan="1" colspan="1">9.5 mm</td>
<td valign="top" align="right" rowspan="1" colspan="1">4.5 mm</td>
<td valign="top" align="center" rowspan="1" colspan="1">No</td>
<td valign="top" align="center" rowspan="1" colspan="1">Abutment neck with screw</td>
<td valign="top" align="center" rowspan="1" colspan="1">Yes</td>
<td valign="top" align="center" rowspan="1" colspan="1">77</td>
<td valign="top" align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td valign="top" align="center" rowspan="1" colspan="1">9</td>
<td valign="top" align="center" rowspan="1" colspan="1">Male</td>
<td valign="top" align="center" rowspan="1" colspan="1">42</td>
<td valign="top" align="center" rowspan="1" colspan="1">26</td>
<td valign="top" align="center" rowspan="1" colspan="1">No</td>
<td valign="top" align="right" rowspan="1" colspan="1">11 mm</td>
<td valign="top" align="right" rowspan="1" colspan="1">4.5 mm</td>
<td valign="top" align="center" rowspan="1" colspan="1">Yes</td>
<td valign="top" align="center" rowspan="1" colspan="1">Abutment neck with screw</td>
<td valign="top" align="center" rowspan="1" colspan="1">Yes</td>
<td valign="top" align="center" rowspan="1" colspan="1">84</td>
<td valign="top" align="center" rowspan="1" colspan="1">Bruxism</td>
</tr>
<tr><td valign="top" align="center" rowspan="1" colspan="1">10</td>
<td valign="top" align="center" rowspan="1" colspan="1">Male</td>
<td valign="top" align="center" rowspan="1" colspan="1">42</td>
<td valign="top" align="center" rowspan="1" colspan="1">17</td>
<td valign="top" align="center" rowspan="1" colspan="1">No</td>
<td valign="top" align="right" rowspan="1" colspan="1">14 mm</td>
<td valign="top" align="right" rowspan="1" colspan="1">4.5 mm</td>
<td valign="top" align="center" rowspan="1" colspan="1">No</td>
<td valign="top" align="center" rowspan="1" colspan="1">Abutment neck with screw</td>
<td valign="top" align="center" rowspan="1" colspan="1">Yes</td>
<td valign="top" align="center" rowspan="1" colspan="1">37</td>
<td valign="top" align="center" rowspan="1" colspan="1"></td>
</tr>
</tbody>
</table>
</alternatives>
</table-wrap>
</floats-group>
</pmc>
<affiliations><list><country><li>Corée du Sud</li>
</country>
</list>
<tree><country name="Corée du Sud"><noRegion><name sortKey="Shim, Hye Won" sort="Shim, Hye Won" uniqKey="Shim H" first="Hye Won" last="Shim">Hye Won Shim</name>
</noRegion>
<name sortKey="Yang, Byoung Eun" sort="Yang, Byoung Eun" uniqKey="Yang B" first="Byoung-Eun" last="Yang">Byoung-Eun Yang</name>
</country>
</tree>
</affiliations>
</record>
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