Implantoplasty and the risk of fracture of narrow implants with advanced bone loss: A laboratory study

To assess the impact of implantoplasty (IP) on maximum implant failure strength of narrow diameter implants of different type/design and material, with simulated advanced bone loss.Narrow, parallel-walled implants (3.3 mm in diameter × 10 mm long) with an internal connection of different type/design [bone level (BL), tissue level (TL)] and material [Titanium grade IV (Ti), Titanium-Zirconium alloy (TiZr)] from one specific manufacturer were used. Half of the implants were subjected to IP in their coronal 5 mm; the remaining were used as controls (seven implants per group). Dynamic loading prior to maximum load strength testing was included.During dynamic loading, the fracture rate of BL implants was low and independent of IP, while that of TL implants increased significantly with IP compared with controls (p = .001). Maximum implant failure strength reduction (in %) due to IP, was 1.3%-25.4%; TiZr BL implants were least affected. Implants subjected to IP compared to those without IP as well as TL implants compared to BL implants showed a significantly lower maximum implant failure strength (p < .002); implant material was not significant (p = .845).Based on data from implants of one specific manufacturer, IP has a significant negative impact on the fracture strength of narrow implants suffering from advanced peri-implantitis. TL implants have been more severely affected compared to BL implants and presented an increased risk for failure during normal chewing forces. In addition, this negative impact of IP on TL implants was independent of the implant material (i.e., Ti or TiZr).Narrow single TL implants with advanced horizontal bone loss (e.g., 5 mm), when subjected to IP, appear to have an increased fracture risk during normal function.