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DENTAL IMPLANTS
FORENSIC ENGINEERING PROCESS REVIEW
BANGAYANDELA MERCEDEBUENFERNANDEZLIMROMAN
CASE BACKGROUND
A team lead by the Dr. Michael Gahlert evaluated the source
of failure of 13 out of 170 test zirconia dental implants, Z-Look3
(3.25 mm, 4mm, 5mm)
-randomly recruited 79 test patients in Germany
-test monitoring period: Oct. 2004- Sept. 2007
-Why? clinical evaluation studies that focus on the
long-term loading of new generation zirconia implants are
limited and rare
M. Ghalert, et. al (2011) Failure analysis of
fractured dental zirconia implants
Z-Look3 Series
Zsystems:
The Study:
1 out 50 dental
implant patients
experience implant
failure
about 3 out of 50
patients
experienced
implant failure
Implant sizes
Image from: http://beautysetter.com/dental-implants-101
METHODOLOGY
1. Collection of background data and sample collection
2. Preliminary examination of the failed part
3. Non-destructive testing
4. Mechanical testing
5. Specimen selection, ID, preservation, and/or cleaning
6. Macroscopic examination and analysis
7. Microscopic examination and analysis
8. Metallographic selection, selection and preparation
9. Metallographic section examination and analysis
10. Determination of failure mechanism
11. Chemical analysis
12. Analysis of fracture mechanics
13. Testing under simulated service conditions
14. Analysis of all evidence, formulation of conclusions, report writing
*Steps above are taken from the Stages in Failure Analysis in ASM
Handbook - Practices in Failure Analysis
METHODOLOGY
1. Collection of background data and sample collection
2. Preliminary examination of the failed part
3. Specimen selection, ID, preservation, and/or cleaning
4. Macroscopic examination and analysis
5. Microscopic examination and analysis
METHODOLOGY:
1. Collection of background
data and sample collection
Z-Look3
Manufacturer: Z-Systems AG, Konstanz, Germany
Composition: Zirconium Dioxide(95%)
Yttrium and Aluminum oxides as Stabilizers (5%)
13 FAILED implants
10 implants from single tooth replacement
2 implants from bridge placed on two implants in
the mandible
1 implant from cantilever bridge post
M. Ghalert, et. al (2011) Failure analysis of fractured
dental zirconia implants
METHODOLOGY:
1. Collection of background
data and sample collection
METHODOLOGY:
1. Collection of background
data and sample collection
METHODOLOGY:
1. Collection of background
data and sample collection
METHODOLOGY:
2. Preliminary Examination of
the Failed Part
METHODOLOGY:
2. Preliminary Examination of
the Failed Part
METHODOLOGY:
METHODOLOGY:
4/5. Macroscopic/Microscopic
examination and analysis
Patient #1
Patient #5
M. Ghalert, et. al (2011) Failure analysis of fractured dental zirconia implants
Patient #7
crack propagation
notch
- initiated crack
METHODOLOGY:
LATERAL VIEW
image from
6. Determination of Failure
Mechanism
PATH OF PROPAGATION
http://www.sporcle.com/games/kingzak0014/anatomyofskulllateral
METHODOLOGY:
6. Determination of Failure
Mechanism
METHODOLOGY:
notch
- initiated crack
6. Determination of Failure
Mechanism
METHODOLOGY:
7. Analysis of Failure
Mechanics
M. Ghalert, et. al (2011) Failure analysis
of fractured dental zirconia implants
Fracture due to
OVERLOAD BREAKAGE
/ FORCED RUPTURE
METHODOLOGY:
7. Analysis of Failure
Mechanics
M. Ghalert, et. al (2011) Failure analysis
of fractured dental zirconia implants
METHODOLOGY:
CONSEQUENCES
In the main article, there
are no stated litigation and
criminal implications.
However, Z-Look3 units
were removed from the
market during 2011.
In 2010, the paper Failure
analysis of fractured dental
zirconia implants involving
Z-Look3 implants were
submitted.
Every preceding year, a
new generation of zirconia
implants were released in
the market.
http://zsystems.com/en/zsystems/history.html
CONSEQUENCES:PRODUCT COMPARISON
SOURCE: ZIRKOLITH PRODUCT CATALOG
http://zsystems.com/fileadmin/user_upload/pdf/zsystems_produktkatalog_11_15_en.pdf
2013
2014
2012
2013/2014
CONSEQUENCES:PRODUCT COMPARISON
http://zsystems.com/en/doctors/products-z5-zirkolithr-ceramic-implants/z5m-zirkolithr-implant.html
CONSEQUENCES:PRODUCT COMPARISON
http://zsystems.com/en/doctors/products-z5-zirkolithr-ceramic-implants/z5m-zirkolithr-implant.html
CONSEQUENCES:PRODUCT COMPARISON
http://zsystems.com/en/doctors/products-z5-zirkolithr-ceramic-implants/z5m-zirkolithr-implant.html
CONSEQUENCES:PRODUCT COMPARISON
http://zsystems.com/en/doctors/products-z5-zirkolithr-ceramic-implants/z5m-zirkolithr-implant.html
Use of Selective
Laser Melting (SLM)
procedure to
develop and patent
the SLM(R) surface.
SOURCE: ZIRKOLITH PRODUCT CATALOG http://zsystems.com/fileadmin/user_upload/pdf/zsystems_produktkatalog_11_15_en.pdf
CONSEQUENCES: Osseointegration
Improved osseointegration
The osseointegration of the latest
generation of Zirkolith ceramic
implants is > 98% and is comparable
with leading titanium implants.
RECOMMENDATIONS
1. Collection of background data and sample collection
2. Preliminary examination of the failed part
3. Non-destructive testing
4. Mechanical testing
5. Specimen selection, ID, preservation, and/or cleaning
6. Macroscopic examination and analysis
7. Microscopic examination and analysis
8. Metallographic selection, selection and preparation
9. Metallographic section examination and analysis
10. Determination of failure mechanism
11. Chemical analysis
12. Analysis of fracture mechanics
13. Testing under simulated service conditions
14. Analysis of all evidence, formulation of conclusions, report
writing
RECOMMENDATIONS
Acquire previous studies on the mechanical
behavior of zirconia dental implants.
Perform additional preliminary
investigations (NDT) on both the as
prepared (in vitro) and clinically used
dental implants
Perform mechanical tests on both the as
prepared (in vitro) and clinically used
dental implants
References
M. Ghalert, et. al. Failure analysis of fractured dental zirconia implants, Vol. 23. John
Wiley and Sons, 2011.
ASM Handbook - Practices in Failure Analysis
ZIRKOLITH PRODUCT CATALOG
http://zsystems.com/fileadmin/user_upload/pdf/zsystems_produktkatalog_11_15_en.pdf
dentalimplants.uchc.edu/about/surgery_osseointegration.html
http://zsystems.com/en/doctors/products-z5-zirkolithr-ceramic-implants/z5m-zirkolithrimplant.html
http://zsystems.com/en/zsystems/history.html