{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T23:29:04Z","timestamp":1793402944175,"version":"4.5.0"},"reference-count":70,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2024,6,28]],"date-time":"2024-06-28T00:00:00Z","timestamp":1719532800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Italian Ministry of Health\u2014Current research IRCCS"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dentistry Journal"],"abstract":"<jats:p>Dental implant fractures pose a significant challenge to long-term treatment success. This systematic review aims to comprehensively examine the clinical factors influencing dental implant fractures (IFs). Furthermore, strategies to choose the right type of implant and prevent this complication are addressed. A systematic search was conducted across PubMed, Scopus, and Web of Science databases. Eligible studies included retrospective case\u2013control, prospective cohort studies, and clinical trials. The initial search yielded 361 articles, of which 312 were excluded being these reviews, case reports, irrelevant, or written in languages other than English. This left 49 articles, with only 6 meeting the eligibility criteria for an in-depth review. These studies, all retrospective case\u2013control, examine implant characteristics, patient demographics, surgical and prosthetic variables, biomechanical and functional factors, clinical and procedural variables, complications and maintenance issues. The risk of bias was assessed as low using the ROBINS-I tool. Key findings suggest a correlation between implant diameter and structural resistance, with wider implants demonstrating reduced fracture risk. Additionally, posterior regions, especially molars and premolars, exhibit higher susceptibility to IFs due to increased masticatory forces. Implant design and material may considerably influence fracture risk, with conical implants and screw-retained prostheses showing higher vulnerability. Biomechanical overload, particularly in patients with bruxism, emerges as a primary contributing factor to IFs. Prosthesis type significantly influences fracture incidence, with cantilever prostheses posing a higher risk due to increased stress. Peri-implant bone loss is strongly associated with IFs, emphasizing the need for meticulous preoperative assessments and individualized management strategies. Future research should prioritize larger and heterogeneous populations with long-term follow-up and standardized methodologies to enhance the generalizability and comparability of findings. Randomized controlled trials and biomechanical studies under controlled conditions are also essential to elucidate the complex interactions contributing to IFs and developing effective prevention strategies. Additionally, integrating patient-reported outcomes may offer a comprehensive understanding of the impact of IFs on quality of life.<\/jats:p>","DOI":"10.3390\/dj12070200","type":"journal-article","created":{"date-parts":[[2024,6,28]],"date-time":"2024-06-28T06:51:53Z","timestamp":1719557513000},"page":"200","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Clinical Factors on Dental Implant Fractures: A Systematic Review"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8270-763X","authenticated-orcid":false,"given":"Mattia","family":"Manfredini","sequence":"first","affiliation":[{"name":"Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy"},{"name":"Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3739-1490","authenticated-orcid":false,"given":"Pier Paolo","family":"Poli","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy"},{"name":"Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0025-9402","authenticated-orcid":false,"given":"Luca","family":"Giboli","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy"},{"name":"Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Beretta","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy"},{"name":"Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Maiorana","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy"},{"name":"Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0867-5398","authenticated-orcid":false,"given":"Matteo","family":"Pellegrini","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy"},{"name":"Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"999","DOI":"10.11607\/jomi.7007","article-title":"Long-term retrospective observational cohort study on the survival rate of stepped screw titanium implants followed up to 20 years","volume":"34","author":"Lini","year":"2019","journal-title":"Int. J. Oral Maxillofac. Implants."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"S278","DOI":"10.1111\/jcpe.12956","article-title":"Peri-implant health, peri-implant mucositis, and peri-implantitis: Case definitions and diagnostic considerations","volume":"45","author":"Renvert","year":"2018","journal-title":"J. Clin. Periodontol."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Poli, P.P., de Miranda, F.V., Polo, T.O.B., Santiago J\u00fanior, J.F., Lima Neto, T.J., Rios, B.R., Assun\u00e7\u00e3o, W.G., Ervolino, E., Maiorana, C., and Faverani, L.P. (2021). Titanium Allergy Caused by Dental Implants: A Systematic Literature Review and Case Report. Materials, 14.","DOI":"10.3390\/ma14185239"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1111\/clr.12843","article-title":"Five-year retrospective study on success, survival and incidence of complications of single crowns supported by dental implants","volume":"28","author":"Tey","year":"2017","journal-title":"Clin. Oral Implants Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"802","DOI":"10.1097\/ID.0000000000000653","article-title":"Incidence and management of fractured dental implants: Case reports","volume":"26","author":"Jin","year":"2017","journal-title":"Implant Dent."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1111\/clr.12898","article-title":"Dental implants in the elderly population: A systematic review and meta-analysis","volume":"28","author":"Srinivasan","year":"2017","journal-title":"Clin. Oral Implants Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1111\/joor.12431","article-title":"Bruxism and dental implant failures: A multilevel mixed effects parametric survival analysis approach","volume":"43","author":"Chrcanovic","year":"2016","journal-title":"J. Oral Rehabil."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1016\/j.jobcr.2023.02.009","article-title":"Mechanical failures of dental implants and supported prostheses: A systematic review","volume":"13","author":"Verma","year":"2023","journal-title":"J. Oral Biol. Craniofac. Res."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"287","DOI":"10.4103\/jispcd.JISPCD_318_21","article-title":"Retrieval of Fractured Implant Abutment Screws: A Narrative Review","volume":"12","author":"Nayana","year":"2022","journal-title":"J. Int. Soc. Prev. Community Dent."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Attard, L., Lee, V., Le, J., Lowe, C., Singh, V., Zhao, J., and Sharma, D. (2022). Mechanical Factors Implicated in Zirconia Implant Fracture Placed within the Anterior Region-A Systematic Review. Dent. J., 10.","DOI":"10.3390\/dj10020022"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Aromataris, E., and Munn, Z. (2024, January 12). JBI Manual for Evidence Synthesis. Available online: https:\/\/synthesismanual.jbi.global.","DOI":"10.46658\/JBIMES-24-01"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ."},{"key":"ref_13","unstructured":"National Heart, Lung, and Blood Institute (2024, January 12). Study Quality Assessment Tool, Available online: https:\/\/www.nhlbi.nih.gov\/health-topics\/study-quality-assessment-tools."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Bufal\u00e1 P\u00e9rez, M., Zubizarreta-Macho, \u00c1., Borrajo S\u00e1nchez, J., Hern\u00e1ndez Rodr\u00edguez, J., Alonso P\u00e9rez-Barquero, J., Riad Deglow, E., and Hern\u00e1ndez Montero, S. (2022). Removal capability, implant-abutment connection damage and thermal effect using ultrasonic and drilling techniques for the extraction of fractured abutment screws: An in vitro study. BMC Oral Health, 221.","DOI":"10.1186\/s12903-022-02653-w"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.prosdent.2020.11.038","article-title":"Effects of different switched or not-switched implant and abutment platform designs and marginal bone loss on fracture strength: An in vitro study","volume":"128","author":"Gehrke","year":"2022","journal-title":"J. Prosthet. Dent."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Khorshidparast, S., Akhlaghi, P., Rouhi, G., and Barikani, H. (2023). Measurement of bone damage caused by quasi-static compressive loading-unloading to explore dental implants stability: Simultaneous use of in-vitro tests, \u03bc-CT images, and digital volume correlation. J. Mech. Behav. Biomed. Mater., 138.","DOI":"10.1016\/j.jmbbm.2022.105566"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Leit\u00e3o-Almeida, B., Camps-Font, O., Correia, A., Mir-Mari, J., Figueiredo, R., and Valmaseda-Castell\u00f3n, E. (2020). Effect of crown to implant ratio and implantoplasty on the fracture resistance of narrow dental implants with marginal bone loss: An in vitro study. BMC Oral Health, 20.","DOI":"10.1186\/s12903-020-01323-z"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1111\/clr.13754","article-title":"Reduced fracture load of dental implants after implantoplasty with different instrumentation sequences. An in vitro study","volume":"32","author":"Jorio","year":"2021","journal-title":"Clin. Oral Implants Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1177\/08987564211044940","article-title":"Correlation of Fracture Resistance of Dental Implants and Bite Force in Dogs described in the literature: An In VitroStudy","volume":"38","author":"Gehrke","year":"2021","journal-title":"J. Vet. Dent."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1016\/j.jmbbm.2017.03.022","article-title":"Fracture strength and probability of survival of narrow and extra-narrow dental implants after fatigue testing: In vitro and in silico analysis","volume":"71","author":"Bordin","year":"2021","journal-title":"J. Mech. Behav. Biomed. Mater."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1319.e1","DOI":"10.1016\/j.prosdent.2022.09.018","article-title":"Connector design effects on the in vitro fracture resistance of 3-unit monolithic prostheses produced from 4 CAD-CAM materials","volume":"128","author":"Kim","year":"2022","journal-title":"J. Prosthet. Dent."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1016\/j.ijom.2018.12.009","article-title":"Evaluation of the surface damage of dental implants caused by different surgical protocols: An in vitro study","volume":"48","author":"Streckbein","year":"2019","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1288","DOI":"10.1111\/clr.13825","article-title":"Fracture resistance and crystal phase transformation of a one- and a two-piece zirconia implant with and without simultaneous loading and aging-An in vitro study","volume":"32","author":"Burkhardt","year":"2021","journal-title":"Clin. Oral Implants Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"337","DOI":"10.11607\/jomi.7009","article-title":"Zirconium Oxide Three-Unit Fixed Partial Denture Frameworks Supported by Dental Implants in Acceptable and Reduced Interocclusal Space Possibilities: Pilot In Vitro Fracture Strength and Fractographic Analyses","volume":"34","author":"Gehrke","year":"2019","journal-title":"Int. J. Oral Maxillofac. Implants"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"720","DOI":"10.1016\/j.prosdent.2019.10.014","article-title":"In vitro comparison of the efficacy of two fractured implant-prosthesis screw extraction methods: Conventional versus mechanical","volume":"124","year":"2020","journal-title":"J. Prosthet. Dent."},{"key":"ref_26","first-page":"e611","article-title":"Effect of bone loss on the fracture resistance of narrow dental implants after implantoplasty. An in vitro study","volume":"26","author":"Correia","year":"2021","journal-title":"Med. Oral Patol. Oral Cir. Bucal."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1016\/j.prosdent.2020.08.008","article-title":"In vitro performance and fracture resistance of interim conventional or CAD-CAM implant-supported screw- or cement-retained anterior fixed partial dentures","volume":"126","author":"Bauer","year":"2021","journal-title":"J. Prosthet. Dent."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1016\/S0022-3913(13)60306-6","article-title":"Fracture resistance of titanium and zirconia abutments: An in vitro study","volume":"109","author":"Foong","year":"2013","journal-title":"J. Prosthet. Dent."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"497","DOI":"10.17219\/dmp\/170311","article-title":"Strain gauge analysis and fracture resistance of implant-supported PEKK hybrid abutments restored with two crown materials: An in vitro study","volume":"60","author":"Aboelfadl","year":"2023","journal-title":"Dent. Med. Probl."},{"key":"ref_30","first-page":"456","article-title":"In vitro assessment of mandibular single\/two implant-retained overdentures using stress-breaking attachments","volume":"23","author":"Kono","year":"2014","journal-title":"Implant. Dent."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"351","DOI":"10.17219\/dmp\/123932","article-title":"In vitro comparison of commercial and ultrafine-grained titanium osteosynthesis miniplates used on mandibular fractures","volume":"57","author":"Asl","year":"2020","journal-title":"Dent. Med. Probl."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Emam, M., and Arafa, A.M. (2023). Stress distribution and fracture resistance of green reprocessed polyetheretherketone (PEEK) single implant crown restorations compared to unreprocessed PEEK and Zirconia: An in-vitro study. BMC Oral Health, 23.","DOI":"10.1186\/s12903-023-02943-x"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"567","DOI":"10.11607\/jomi.7106","article-title":"Performance of a repair service set for the retrieval of fractured abutment screws: A pilot in vitro study","volume":"34","author":"Igarashi","year":"2019","journal-title":"Int. J. Oral Maxillofac. Implants"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1263","DOI":"10.1007\/s00784-018-2558-z","article-title":"Diagnosis of vertical root fracture in teeth close and distant to implant: An in vitro study to assess the influence of artifacts produced in cone beam computed tomography","volume":"23","author":"Freitas","year":"2019","journal-title":"Clin. Oral Investig."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1111\/cid.13157","article-title":"Implant deformation and implant-abutment fracture resistance after standardized artificial aging: An in vitro study","volume":"25","author":"Zhai","year":"2023","journal-title":"Clin. Implant. Dent. Relat. Res."},{"key":"ref_36","first-page":"53","article-title":"Use of abutment-teeth vs. dental implants to support all-ceramic fixed partial dentures: An in-vitro study on fracture strength","volume":"29","author":"Kokubo","year":"2005","journal-title":"Swed. Dent. J."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1007\/s00784-013-1039-7","article-title":"Influence of bone insertion level of the implant on the fracture strength of different connection designs: An in vitro study","volume":"18","author":"Gehrke","year":"2014","journal-title":"Clin. Oral Investig."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1016\/j.prosdent.2014.04.016","article-title":"Fracture force of cantilevered zirconia frameworks: An in vitro study","volume":"112","author":"Chong","year":"2014","journal-title":"J. Prosthet. Dent."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"808","DOI":"10.1111\/j.1600-0501.2010.02067.x","article-title":"The effects of cyclic loading and preparation on the fracture strength of zirconium-dioxide implants: An in vitro investigation","volume":"22","author":"Kohal","year":"2011","journal-title":"Clin. Oral Implants Res."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"4215","DOI":"10.1007\/s00784-023-05038-7","article-title":"In vitro fatigue and fracture testing of temporary materials from different manufacturing processes in implant-supported anterior crowns","volume":"27","author":"Bein","year":"2023","journal-title":"Clin. Oral Investig."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Lin, J., Cai, P., Zhuo, Y., Lin, L., and Zheng, Z. (2023). Effect of abutment design on fracture resistance of resin-matrix ceramic crowns for dental implant restoration: An in vitro study. BMC Oral Health, 23.","DOI":"10.1186\/s12903-023-03100-0"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"521","DOI":"10.11607\/jomi.7899","article-title":"Resistance to Fracture in Fixed Dental Prostheses Over Cemented and Screw-Retained Implant-Supported Zirconia Cantilevers in the Anterior Region: An In Vitro Study","volume":"35","author":"Rues","year":"2020","journal-title":"Int. J. Oral Maxillofac. Implants"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1111\/jopr.13127","article-title":"Implant Angulation Effect on the Fracture Resistance of Monolithic Zirconia Custom Abutments: An In Vitro Study","volume":"29","author":"Katsavochristou","year":"2020","journal-title":"J. Prosthodont."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1002\/cre2.558","article-title":"Comparison of porcelain veneer fracture in implant-supported fixed full-arch prostheses with a framework of either titanium, cobalt-chromium, or zirconia: An in vitro study","volume":"8","author":"Johansson","year":"2022","journal-title":"Clin. Exp. Dent."},{"key":"ref_45","first-page":"850","article-title":"In vitro study of the influence of the type of connection on the fracture load of zirconia abutments with internal and external implant-abutment connections","volume":"24","author":"Sailer","year":"2009","journal-title":"Int. J. Oral Maxillofac. Implants"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"3747","DOI":"10.1016\/j.actbio.2010.03.012","article-title":"Teeth restored using fiber-reinforced posts: In vitro fracture tests and finite element analysis","volume":"6","author":"Schmitter","year":"2010","journal-title":"Acta Biomater."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"501.e1","DOI":"10.1016\/j.prosdent.2020.10.013","article-title":"Effect of aging on fracture resistance and torque loss of restorations supported by zirconia and polyetheretherketone abutments: An in vitro study","volume":"125","author":"Ghodsi","year":"2021","journal-title":"J. Prosthet. Dent."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1111\/cid.12165","article-title":"Importance of Crown Height Ratios in Dental Implants on the Fracture Strength of Different Connection Designs: An In Vitro Study","volume":"17","author":"Gehrke","year":"2015","journal-title":"Clin. Implant Dent. Relat. Res."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"503.e1","DOI":"10.1016\/j.prosdent.2020.09.025","article-title":"Fatigue fracture resistance of titanium and chairside CAD-CAM zirconia implant abutments supporting zirconia crowns: An in vitro comparative and finite element analysis study","volume":"125","author":"Giner","year":"2021","journal-title":"J. Prosthet. Dent."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1093\/ejo\/cjq151","article-title":"Fracture resistance of orthodontic mini-implants: A biomechanical in vitro study","volume":"33","author":"Wilmes","year":"2011","journal-title":"Eur. J. Orthod."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/j.prosdent.2005.12.003","article-title":"Fracture resistance of single-tooth implant-supported all-ceramic restorations: An in vitro study","volume":"95","author":"Att","year":"2006","journal-title":"J. Prosthet. Dent."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1016\/j.prosdent.2022.07.005","article-title":"An in vitro evaluation of 2 methods for retrieving fractured abutment screw fragments from the intaglio of 4 different implant systems","volume":"131","author":"Moorthy","year":"2022","journal-title":"J. Prosthet. Dent."},{"key":"ref_53","first-page":"283","article-title":"Fracture resistance of the implant-abutment connection in implants with internal hex and internal conical connections under oblique compressive loading: An in vitro study","volume":"22","author":"Bersani","year":"2009","journal-title":"Int. J. Prosthodont."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1563\/aaid-joi-D-16-00010","article-title":"Fracture Resistance of Implant Abutments Following Abutment Alterations by Milling the Margins: An In Vitro Study","volume":"42","author":"Patankar","year":"2016","journal-title":"J. Oral Implantol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1016\/j.bjoms.2019.07.014","article-title":"Development of a new V-shaped implant with locking plates and screws for mandibular fracture fixation: An in vitro study using finite element analysis","volume":"57","author":"Bhagat","year":"2019","journal-title":"Br. J. Oral Maxillofac. Surg."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1097\/ID.0000000000000392","article-title":"Implant Vertical Fractures Provoked by Laboratory Procedures: A Finite Element Analysis Inspired from Clinical Cases","volume":"25","author":"Takeshita","year":"2016","journal-title":"Implant. Dent."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1111\/j.1600-0501.2011.02206.x","article-title":"Failure analysis of fractured dental zirconia implants","volume":"23","author":"Gahlert","year":"2012","journal-title":"Clin. Oral Implants Res."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1111\/joor.12065","article-title":"Cumulative survival rate and complication rates of single-tooth implant; focused on the coronal fracture of fixture in the internal connection implant","volume":"40","author":"Cha","year":"2013","journal-title":"J. Oral Rehabil."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1866","DOI":"10.1016\/j.joms.2017.05.014","article-title":"What Are the Incidence and Factors Associated With Implant Fracture?","volume":"75","author":"Tabrizi","year":"2017","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1111\/cid.12621","article-title":"Incidence and pattern of implant fractures: A long-term follow-up multicenter study","volume":"20","author":"Lee","year":"2018","journal-title":"Clin. Implant Dent. Relat. Res."},{"key":"ref_61","first-page":"279","article-title":"Analysis of the causes of dental implant fracture: A retrospective clinical study","volume":"49","author":"Stoichkov","year":"2018","journal-title":"Quintessence Int."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1111\/clr.13407","article-title":"Implant fracture failure rate and potential associated risk indicators: An up to 12-year retrospective study of implants in 5,124 patients","volume":"30","author":"Lee","year":"2019","journal-title":"Clin. Oral Implants Res."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1007\/s00784-021-04213-y","article-title":"Oral health-related quality of life and satisfaction in edentulous patients rehabilitated with implant-supported full dentures all-on-four concept: A systematic review","volume":"26","author":"Rocha","year":"2022","journal-title":"Clin. Oral Investig."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1111\/prd.12416","article-title":"Prosthetic failures in dental implant therapy","volume":"88","author":"Sailer","year":"2022","journal-title":"Periodontol. 2000"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1563\/AAID-JOI-D-09-00135.1","article-title":"Osseointegrated implant fracture: Causes and treatment","volume":"37","author":"Gealh","year":"2011","journal-title":"J. Oral Implantol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1016\/j.msec.2016.02.015","article-title":"Comparison of the fracture resistance of dental implants with different abutment taper angles","volume":"63","author":"Wang","year":"2016","journal-title":"Mater. Sci. Eng. C Mater Biol. Appl."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1111\/clr.13499","article-title":"Mechanical and biological complications after implantoplasty-A systematic review","volume":"30","author":"Stavropoulos","year":"2019","journal-title":"Clin. Oral Implants Res."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1111\/clr.13037","article-title":"Effect of implantoplasty on fracture resistance and surface roughness of standard diameter dental implants","volume":"29","author":"Figueiredo","year":"2018","journal-title":"Clin. Oral Implants Res."},{"key":"ref_69","first-page":"e691","article-title":"Fracture resistance after implantoplasty in three implant-abutment connection designs","volume":"25","author":"Figueiredo","year":"2020","journal-title":"Med. Oral Patol. Oral Cir. Bucal."},{"key":"ref_70","unstructured":"Sterne, J.A.C., Higgins, J.P.T., Elbers, R.G., Reeves, B.C., and The Development Group for ROBINS-I (2024, January 12). Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I): Detailed Guidance, Updated 12 October 2016. Available online: http:\/\/www.riskofbias.info."}],"container-title":["Dentistry Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2304-6767\/12\/7\/200\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:06:52Z","timestamp":1760108812000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2304-6767\/12\/7\/200"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,28]]},"references-count":70,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2024,7]]}},"alternative-id":["dj12070200"],"URL":"https:\/\/doi.org\/10.3390\/dj12070200","relation":{},"ISSN":["2304-6767"],"issn-type":[{"value":"2304-6767","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,28]]}}}