The Effect of Implantoplasty on Fracture Resistance and Implant Surface Changes: An In Vitro and Finite Element Analysis Study.

Rayner Goh, Kai Chun Li, Momen A Atieh, Sunyoung Ma, Abigail Oliver, Diana Giraldo, Andrew Tawse-Smith
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Abstract

Introduction: Implantoplasty can be performed on implants diagnosed with peri-implantitis to facilitate implant decontamination and improve access for oral home care. However, its effect on the mechanical strength of the implant is still uncertain. This study aimed to evaluate the effect of implantoplasty on the fracture resistance of dental implants with various degrees of bone loss, as well as its surface changes.

Methods: Eighty 4.2 × 13 mm conical connection dental implants were allocated evenly into four groups based on the bone defect morphology: circumferential or semi-circumferential, and 3 or 5 mm vertical height. Half of the implants underwent implantoplasty with tungsten carbide finishing burs. Weight, volume, and surface roughness of the implants were recorded prior to and after instrumentation. All implants were subjected to static loading to failure or fracture and the implant surfaces were then analyzed using optical microscopy. Finite element analysis was carried out to assess the stress pattern on dental implants after implantoplasty.

Results: Implantoplasty significantly reduced the fracture resistance of implants with all defect morphologies, aside from those with 3 mm of circumferential bone loss. Implants with 5 mm of peri-implant bone loss also experienced significantly reduced fracture resistance compared to the 3 mm group. Significant decrease in fracture resistance was only observed between the circumferential and semi-circumferential groups with 5 mm of bone loss. Surface roughness was also significantly reduced following implantoplasty. The results from finite element analysis revealed a change in pattern of stress concentration in the implant after implantoplasty.

Conclusion: Implantoplasty negatively impacted the fracture resistance of standard diameter dental implants in most scenarios. The increase in exposed implant length resulted in a decrease in fracture resistance. This increase in fracture risk should be considered prior to implantoplasty, especially in implants with more advanced bone loss.

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种植体成形术对抗折性和种植体表面变化的影响:体外和有限元分析研究。
导言:种植体植入术可用于诊断为种植体周围炎的种植体,以促进种植体净化,改善口腔家庭护理的可及性。然而,其对种植体机械强度的影响仍不确定。本研究旨在评估种植体成形术对不同程度骨质流失的牙科种植体的抗折性及其表面变化的影响:方法:根据骨缺损形态将 80 颗 4.2 × 13 毫米的锥形连接种植体平均分为四组:环形或半环形,垂直高度为 3 毫米或 5 毫米。半数种植体使用碳化钨精加工车针进行种植整形。在植入前和植入后,对种植体的重量、体积和表面粗糙度进行了记录。对所有种植体进行静态加载,直至失效或断裂,然后使用光学显微镜对种植体表面进行分析。此外,还进行了有限元分析,以评估种植整形术后牙科种植体的应力模式:结果:种植体植入术明显降低了所有缺损形态种植体的抗折性,只有周缘骨缺失 3 毫米的种植体除外。与 3 毫米组相比,种植体周围骨质流失 5 毫米的种植体的抗折性也明显降低。只有周缘骨质缺失 5 毫米组和半周缘骨质缺失 5 毫米组之间的抗折性才会显著降低。种植体植入后,表面粗糙度也明显降低。有限元分析的结果表明,种植体植入术后种植体的应力集中模式发生了变化:结论:在大多数情况下,种植体植入术对标准直径牙科种植体的抗折性产生了负面影响。种植体暴露长度的增加导致抗折性降低。在进行种植手术前应考虑到骨折风险的增加,尤其是骨质流失较严重的种植体。
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