J Korean Assoc Oral Maxillofac Surg.  2023 Feb;49(1):43-48. 10.5125/jkaoms.2023.49.1.43.

Energy-dispersive X-ray spectroscopic investigation of a fractured non-submerged dental implant associated with abutment fracture

• Nguyen TTH
• Eo MY
• Mustakim KR
• Seo MH
• Myoung H
• Kim SM

• KMID: 2539703
• DOI: http://doi.org/10.5125/jkaoms.2023.49.1.43

Abstract

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.

Keyword

Dental implants; Fatigue fracture; Scanning electron microscopy; Energy dispersive X-ray spectroscopy

Figure

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  Fig. 1 Abutment of the implant was fractured at the same height level as the surrounding alveolar bone. A. A radiolucency was observed on the coronal portion of the fixture, indicating that the fixture body also was fractured (arrow). B. Axial computed tomography showed the location of the fracture at the mesiolingual aspect of the fixture body (arrows). C. The #37i fixture was retrieved with bony attachments after removal using a trephine bur.

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  Fig. 2 Scanning electron microscopy photograph of the failed implant at ×65 magnification. The regions of interest examined by energy dispersive X-ray spectroscopy at ×10,000 magnifications are marked with red rectangles. U: surface in the upper area of the fixture, adjacent to the fracture region, M: implant surface at the middle of the implant fixture, B: attached bone tissue in the middle region of the fixture, A: implant surface in the apical region of the implant.

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  Fig. 3 Scanning electron microscopy-energy dispersive X-ray spectroscopy (SEM-EDS) analysis of the failed implant. SEM micrograph at ×500 and ×10,000 magnifications, EDS elemental distribution map, and spectrum of representative points on the failed implants. U: microfracture (white arrowheads) and scratching lines (black arrows) are observed. The elemental distribution map showed a homogeneous oxidized Ti surface with particles composed of C and Si. M: normal bone structure with bony lacunae covering the fixture surface (blue arrowheads). The Ti surface was detected on EDS in the region with a thin bone layer (black arrowheads). B: SEM images showing irregular bone structure with the presence of organic matter (blue arrowheads). EDS results reveal the presence of Na, F, N, Si, and Au. A: normal bone structure with lacunae covering the fixture surface (blue arrowheads). Trace amounts of Ti can be observed in the elemental distribution map (black arrowheads). (cps/eV: count per second per electron-volt)

Reference

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