임프란트의 합병증과 처치

Abstract

Despite the long-term predictability of endosseous dental implants, some complications do occur including surgical, biologic, mechanical(or technical) and esthetic aspects. To deal with these problems, assessments in clinical states as well as radiographic findings are important. These case reports are to show the complications occurred in the followup period of functionally loaded implants and to find out the treatments of the ailing implants. Both of the case reports showed mechanical(or technical) complications like screw loosening with peri-implant crestal bone loss and some aspects of peri-implantitis which is one of the biologic complications. Mechanical complication, the most common aspect, is known to be largely related to the stress factor. Occlusal overload might cause mechanical problems such as screw loosening, fractures of the screw, fixture body or the prosthetic components. In addition, strain and the bending moment concentrated mainly at the crestal area might cause the initial crestal bone resorption(saucerization) and the late stage bone loss together with peri-implantitis. Treatments of the complications include minimizing occlusal overload, using systemic antibacterial therapy or the chlorhexidin, and the surgical access when the implants are thought to be amendable. Minimizing occlusal overload and distributing the stress can be accomplished by increasing the number, length and the diameter of the implant, tripod positioning of the implants, selecting the implant design which maximizes the surface area and analyzing the occlusion of the patient. In the case reports, many factors were seemed to be related to the complications of the functionally loaded implants. To treat and furthermore, to prevent the complications, treatment plans should be made under the considerations of these factors.