Mini-implants in orthodontics: A systematic review of the literature
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Implant Failure
Implant failure is either failure of the bone-implant surface, resulting in implant motion and loss of fracture stability or by mechanical failure of the implant such as bending or breaking. Implant failure can precipitate serious complications in fracture management if failure occurs before adequate bone healing. In some patients, these problems can be anticipated and avoided by adequate fracture planning preoperatively, good technical skills during surgery, and critical review of the radiographs immediately after surgery. Mechanical failure of implants may occur when the implant is subjected to an acute catastrophically high load but more often results from cyclic load causing fatigue failure of the implant when fracture healing is delayed. Most implant failures occur at weak areas of the implant or implant construct. Implant failure is suspected when an animal presents with acute loss of limb function soon after fracture fixation.
Implant Failure
Mechanical failure
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Comparison of search strategies in systematic reviews of adverse effects to other systematic reviews
Abstract Background Research indicates that the methods used to identify data for systematic reviews of adverse effects may need to differ from other systematic reviews. Objectives To compare search methods in systematic reviews of adverse effects with other reviews. Methods The search methodologies in 849 systematic reviews of adverse effects were compared with other reviews. Results Poor reporting of search strategies is apparent in both systematic reviews of adverse effects and other types of systematic reviews. Systematic reviews of adverse effects are less likely to restrict their searches to MEDLINE or include only randomised controlled trials ( RCT s). The use of other databases is largely dependent on the topic area and the year the review was conducted, with more databases searched in more recent reviews. Adverse effects search terms are used by 72% of reviews and despite recommendations only two reviews report using floating subheadings. Conclusions The poor reporting of search strategies in systematic reviews is universal, as is the dominance of searching MEDLINE . However, reviews of adverse effects are more likely to include a range of study designs (not just RCT s) and search beyond MEDLINE .
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The goal of this study was to assess risk factors for dental implant failure. Eighty-three implants were placed in thirty patients who were followed for three years using digital subtraction radiography. The following putative risk factors for implant failure were employed in the model: age, sex, implant length, implant position, implant surface coating, smoking habit, and presence of infection. Implant failure was defined as progressive bone loss compromising the implant. We found that the presence of infection (P < 0.001) and absence of HA coating (P < 0.001) were the primary factors associated with early implant failure.
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Introduction: Proximal femur locking compression plates (PF-LCP) have gained popularity since their inception due to superior biomechanical stability and durability but clinical experience has shown conflicting results including implant failure. Objective: To study the incidence of implant failure in patients with sub-trochanteric fractures managed with proximal femoral locking compression plate and identify potential risk factors associated with the failure. Materials & Methods: Fifty patients with sub-trochanteric fractures, operated upon with titanium PF-LCP were included in the study from January 2012 to December 2014. These plates were of two designs including one five 5.0 mm proximal locking screws (implant A) and other with three 6.5 mm proximal locking screws (implant B). Fractures were classified according to AO/OTA and Seinsheimer classification. Patients had regular follow-up visits for at least a year, allowing for clinical and radiological assessment of union and implant-related complications. Results: A total of 13 out of 50 (26%) plates failed of which 7 were implant fractures, 3 screw breakage and 3 screw cut outs. 70% of the failures occurred in elderly females. Overall implant failure was significantly more common in patients >50 years (p 0.04). Comparing the two different designs of implants used, implant A was more likely to fail at a plate screw density of 0.8 or more (p 0.02), whereas implant B was associated with significant failure when less than 4 proximal screws were used (p 0.03). Conclusion: This study revealed a high failure rate (26%) of this implant. Attention to the neck shaft angle difference, number of proximal screws and plate screw density may help reduce failure rates, particularly in elderly osteoporotic females.
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Although transcrestal sinus floor elevation (TSFE) is widely used for cases of insufficient residual bone height in the posterior maxilla, few studies focus on the risk factors of early implant failure associated with TSFE procedures. This study aimed to identify and summarize the possible risk factors of implant failure associated with TSFE to ensure a more predictable implant survival rate using TSFE. We report the treatment of a patient with implant failure following TSFE and discuss this case's possible associated risk factors. A standard implant with a diameter of 4.8 mm and length of 10 mm was used after the TSFE procedure. Implant loosening was suddenly observed 6 weeks after the initial surgery. Factors that could result in early implant failure included patient-related risk factors, anatomical factors of the operational area, and operation- and implant-related factors. Within the current study's limitations, the graft material particles between the implant surface and socket could be considered a direct risk factor resulting in implant failure. Therefore, more attention should be paid to socket cleaning during the TSFE procedure, and loose particulate grafting materials should be discouraged. Another significant consideration for implant loss is the possibility of fractures in the buccal or palatal cortical plates during the site preparation and implant insertion. Thus, these factors should be studied further and receive more clinical attention.
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Despite the clinical effectiveness of joint replacement arthroplasty, a number of complications, most of which present clinically with signs and symptoms related to implant loosening, are associated with this procedure. Histological changes that occur in soft tissue and bone around an implant provide diagnostic information on the causes of implant loosening and give clues as to the nature of the pathological processes that lead to this and other complications of implant-related joint disease. These pathological processes include the biologically nonspecific body macrophage response to wear particles (aseptic loosening), a specific hypersensitivity immune reaction to implant-derived wear particles, infection (septic loosening), primary joint-related pathology in revision arthroplasty tissues, and tumor formation in peri-implant tissues. This review outlines pathological changes that reflect pathogenetic mechanisms contributing to implant loosening and other complications in peri-implant tissues.
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In this article, we describe the strengths and weaknesses of several methods of locating systematic reviews, including electronic databases such as MEDLINE, Best Evidence (the electronic version of ACP Journal Club and Evidence-Based Medicine), and the Cochrane Library (a regularly updated source of reviews and controlled trials produced by the Cochrane Collaboration). We also present steps that can be used to critically appraise review articles; as an example, we use a systematic review that evaluates the gastrointestinal toxicity of various nonsteroidal anti-inflammatory drugs in the context of a clinical scenario.
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A BSTRACT Objective: This study’s goal was to assess the failure rate and peri-implant complications of single-piece implant systems over the course of a one-year follow-up. Materials and Methods: Patient records were examined retrospectively. 150 single-piece dental implants were analyzed. Clinical results, implant features, and demographic information were gathered. Implant failure, which is characterized as the total loss of osseointegration, served as the key outcome indicator. Patient satisfaction and peri-implant problems were secondary outcomes. Data analysis employed descriptive statistics. Results: During the one-year follow-up period, the failure rate for single-piece implant systems was 6.7%. The two main factors leading to implant failure were found to be poor osseointegration (60%) and biomechanical overload (40%). 20% of the cases had peri-implant problems, such as peri-implantitis. 85% of the panelists felt that single-piece implants had satisfied their patients. Conclusion: A 6.7% failure rate in single-piece implant systems was seen in this one-year follow-up investigation. The major causes of implant failure were found to be poor osseointegration and biomechanical loading. In 20% of the cases, peri-implant problems such as peri-implantitis, were noted. There was great patient satisfaction. These results highlight the significance of regulating occlusal forces, optimizing osseointegration, and applying preventive measures to ensure the long-term viability of single-piece implant systems.
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The advancement in the material of spinal implant and technique of spinal instrumentation has led to an increase in spine surgeries. The final desired outcome of spine surgery involving instrumentation is fusion. There is a race among implants to fail and bone to fuse. If there is a formation of pseudoarthrosis or failure to fuse then implants are bound to fail. The most common presentation of pseudoarthrosis is implant breakage. Hence, should we label every implant that has presented with breakage as a “failure”? In this article, we have discussed our experience of two cases presented to us with implant breakage but which were managed successfully with conservative methods. Both of our cases did well without any surgical intervention. We have follow-ups of seven years in one case and five years in the other. Every patient with pseudoarthrosis does not require surgical management and hence, every implant breakage should not be labeled as implant “failure”.
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Breakage
Presentation (obstetrics)
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Background: This study investigated the risk of reconstruction failure after mastectomy, immediate breast reconstruction, and radiotherapy to either a temporary tissue expander or permanent implant. Methods: Records of women treated at a single institution between June of 1997 and December of 2011 were reviewed. Two patient groups were identified based on type of immediate breast reconstruction: tissue expander followed by exchange with a permanent implant and permanent implant. The study endpoint was rate of reconstruction failure, defined as a replacement, loss of the implant, or conversion to flap. Results: The tissue expander/permanent implant and the permanent implant groups consisted of 63 and 75 patients, respectively. The groups were well balanced for clinical and treatment characteristics. With a median follow-up of 116 months, eight implant losses, 50 implant replacements, and four flap conversions were recorded. Reconstruction failure occurred in 22 of 63 patients in the expander/implant group and in 40 of 75 patients in the permanent implant group. A traditional proportional hazards model showed a higher risk of reconstruction failure for the expander/implant group (hazard ratio, 2.01) and a significantly shorter time to reconstruction failure compared with the permanent implant group (109.2 months versus 157.7 months; p = 0.03); however, according to a competing risk model, the between-groups cumulative incidences were not significantly different (hazard ratio, 1.09). Conclusions: Radiotherapy to either a tissue expander or a permanent implant presented a fairly large risk of reconstruction failure over time. The expander/implant group was not more likely to develop reconstruction failure compared to permanent implant group, but the timing of onset was shorter. More complex techniques should be investigated to lower the risk of reconstruction failure. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
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