Nguyen Truc Thi Hoang, Eo Mi Young, Mustakim Kezia Rachellea, Seo Mi Hyun, Myoung Hoon, Kim Soung Min
Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea.
Oral and Maxillofacial Microvascular Reconstruction LAB, Brong Ahafo Regional Hospital, Sunyani, Ghana.
J Korean Assoc Oral Maxillofac Surg. 2023 Feb 28;49(1):43-48. doi: 10.5125/jkaoms.2023.49.1.43.
The biocompatibility and durability of implant fixtures are major concerns for dentists and patients. Mechanical complications of the implant include abutment screw loosening, screw fracture, loss of implant prostheses, and implant fracture. This case report aims to describe management of a case of fixture damage that occurred after screw fracture in a tissue level, internal connection implant and microscopic evaluation of the fractured fixture. A trephine bur was used to remove the fixture, and the socket was grafted using allogeneic bone material. The failed implant was examined by scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS), which revealed a fractured fixture with both normal and irregular bone patterns. The SEM and EDS results give an enlightenment of the failed fixture surface micromorphology with microfracture and contaminated chemical compositions. Noticeably, the significantly high level of gold (Au) on the implant surface and the trace amounts of Au and titanium (Ti) in the bone tissue were recorded, which might have resulted from instability and micro-movement of the implant-abutment connection over an extended period of time. Further study with larger number of patient and different types of implants is needed for further conclusion.
种植体固定装置的生物相容性和耐用性是牙医和患者主要关注的问题。种植体的机械并发症包括基台螺丝松动、螺丝断裂、种植体修复体脱落和种植体断裂。本病例报告旨在描述一例组织水平、内部连接种植体螺丝断裂后固定装置损坏的处理情况以及对断裂固定装置的微观评估。使用环钻去除固定装置，并使用同种异体骨材料对牙槽窝进行植骨。通过扫描电子显微镜（SEM）和能量色散X射线光谱仪（EDS）对失败的种植体进行检查，结果显示固定装置断裂，伴有正常和不规则的骨形态。SEM和EDS结果揭示了失败固定装置表面的微观形态，包括微骨折和受污染的化学成分。值得注意的是，记录到种植体表面金（Au）含量显著升高，骨组织中存在微量的Au和钛（Ti），这可能是由于种植体-基台连接在较长时间内不稳定和微动所致。需要对更多患者和不同类型的种植体进行进一步研究以得出进一步结论。
