Scanning electron microscopy observations of failures of implant overdenture bars: a case series report.
BACKGROUND
Soldered or cast bars are used as a standard of care in attachment systems supporting maxillary and mandibular implant overdentures. When failures of these bars occur, currently there is a lack of evidence in relation to their specific etiology, location, or nature.


OBJECTIVE
To investigate the failure process of a case series of six failed soldered bars, four intact soldered bars, and one intact cast milled bar, which had been supporting implant overdentures.


METHODS
A total of 11 different overdenture bars were removed from patients with different configuration of opposing arches. A failed bar (FB) group (n = 6) had failed soldered overdenture bars, which were recovered from patients following up to 2 years of wear before requiring prosthodontic maintenance and repair. An intact bar (IB) group (n = 5) had both soldered bars and a single cast milled bar, which had been worn by patients for 2 to 5 years prior to receiving other aspects of prosthodontic maintenance. All bars were examined using scanning electron microscopy to establish the possible mode of failure (FB) or to identify evidence of potential failure in the future (IB).


RESULTS
Evidence of a progressive failure mode of corrosion fatigue and creep were observed on all the FB and IB usually around the solder areas and nonoxidizing gold cylinder. Fatigue and creep were also observed in all the IB. Where the level of corrosion was substantial, there was no evidence of wear from the matrices of the attachment system. Evidence of an instantaneous failure mode, ductile and brittle overload, was observed on the fracture surfaces of all the FB, within the solder and the nonoxidizing gold cylinders, at the solder/cylinder interface.


CONCLUSIONS
Corrosion, followed by corrosion fatigue, appears to be a key factor in the onset of the failure process for overdenture bars in this case series of both maxillary and mandibular overdentures. Limited sample size and lack of standardization identify trends only but prevent broad interpretation of the findings.
Oral Implantology Research Group, Sir John Walsh Research Institute, School of Dentistry, University of Otago, Dunedin, New Zealand.
J Neil
JN
Waddell
Alan G T
AG
Payne
Michael V
MV
Swain
Jules A
JA
Kieser
D000368:Aged; D000369:Aged, 80 and over; D003343:Corrosion; D000044:Dental Abutments; D003735:Dental Casting Technique; D015921:Dental Implants; D019094:Dental Prosthesis, Implant-Supported; D019232:Dental Restoration Failure; D019554:Dental Restoration Wear; D012994:Dental Soldering; D003779:Denture Design; D003780:Denture Repair; D003781:Denture Retention / Q000295:instrumentation*; D003826:Denture, Complete, Lower; D003827:Denture, Complete, Upper; D003828:Denture, Overlay; D055119:Elastic Modulus; D005500:Follow-Up Studies; D006047:Gold Alloys / Q000737:chemistry*; D006801:Humans; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D013314:Stress, Mechanical; D013499:Surface Properties
D015921:Dental Implants; D006047:Gold Alloys