Analysis of causes for dental implant failure / 口腔医学

@#The implant-supported prosthesis has gradually become the preferred treatment for patients with partial edentulous or complete edentulous. Causes for the implant failure have been discussed in the majority of studies conducted in recent years, while their risk factors are still controversial. Patient factors (gender, age, smoking, osteoporosis, diabetes, medication, periodontitis and bruxism), clinical parameters (implant area, bone quality, implant size) and doctor factors (surgical-related factors, prosthesis-related factors) will all affect implant failure. This article presents typical clinical cases and reviews the potential risk factors for dental implant failure, in order to provide guidance for clinical practice.

Early Dental Implant Failure in Patient with Active Implant Periapical Lesions: Lesson Learnt from Two Case Reports

ABSTRACT@#Implant periapical lesion (IPL) is also known as retrograde peri-implantitis and as the name suggests, it involves inflammation surrounding the apical part of the dental implants. Previously, many studies have reported the event of IPL that further delays osseointegration, and some reported failure of implant placement due to this disease. In this article, we described two cases of early dental implant failure that was associated with active IPL and correlated the clinical and radiographical findings with the histopathological findings.

Management of the maxillary sinus complications after dental implantation: a systematic review and meta-analysis / Tratamento das complicações do seio maxilar após cirurgia de implante dentário: Revisão Sistemática e Meta-Análise

Background and aim: Endoscopic sinus surgery owing to its satisfactory prognosis and low complication is considered as the first line of surgical procedure. Implant failure is often reported despite efforts in recent years. The purpose of this study was to review the factors leading to side effects in dental implantation of the maxillary sinus. Material and Methods: The systematic search was performed on electronic databases of MEDLINE, PubMed, Cochrane Library, Embase, ISI, Google scholar to find corresponding articles regarding dental literature during 2010 to 2019. Electronic title management was carried out by Endnote X9 software. Searches were based on the keywords of "dental implants", "Implants"," dental"," maxilla", "sinusitis". Results: The searched potentially relevant titles and abstracts were related to 294 articles, 104 of which were excluded due to lack of study inclusion criteria. At last, 11 articles were included into the final analysis. Postoperative sinusitis was found in 78 patients within 9 articles among 1195 patients. The implant failure was reported in 136 cases and the sinus membrane perforation in 185 sinuses within 11 articles among 1372 sinus lift procedures. Conclusion: The findings showed that the risk factors of sinusitis after implant surgery were Schneiderian membrane rupture and preoperative sinusitis, as well as smoking and residual bone height were the parameters elevating the dental implant failure risk. (AU)

Justificativa e objetivo: A cirurgia endoscópica do seio maxilar, devido ao seu prognóstico satisfatório e baixa complicação, é considerada a primeira opção cirúrgica. A falha do implante é frequentemente relatada, apesar dos esforços realizados nos últimos anos. O objetivo deste estudo foi revisar os fatores que levaram a efeitos colaterais no implante dentário do seio maxilar. Material e Métodos: A busca sistemática foi realizada nas bases de dados eletrônicas do MEDLINE, PubMed, Cochrane Library, Embase, ISI, Google Scholar para encontrar artigos correspondentes sobre literatura odontológica no período de 2010 a 2019. O gerenciamento eletrônico de títulos foi realizado pelo software Endnote X9. As pesquisas foram baseadas nas palavras-chave "implantes dentários", "implantes", "dentário", "maxila", "sinusite". Resultados: Os títulos e resumos potencialmente relevantes pesquisados foram relacionados a 294 artigos, 104 dos quais foram excluídos por falta de critérios de inclusão no estudo. Por fim, 11 artigos foram incluídos na análise final. Sinusite pós-operatória foi encontrada em 78 pacientes em 9 artigos entre 1195 pacientes. A falha do implante foi relatada em 136 casos e a perfuração da membrana sinusal em 185 seios, em 11 artigos, entre 1372 procedimentos de elevação sinusal. Conclusão: Os achados mostraram que os fatores de risco para sinusite após cirurgia de implante foram ruptura da membrana Schneideriana e sinusite pré-operatória, assim como tabagismo e altura óssea residual, os quais foram considerados parâmetros que elevaram o risco de falha do implante dentário. (AU)

“Burden of the Triumph:” Burden of peri-implantitis in Indian population – A mathematical model

India suffers from a heavy burden of oral diseases. Dental implants (DIs) are prescribed widely by the dental practitioners to replace lost natural teeth. There is no estimate, however, to determine the number of DIs or the number of people with peri-implantitis or the failure of implants after placement. In this modeling study, we attempted to estimate the prevalence of adult Indians who would choose DI in the near future and to calculate the peri-implantitis and failure of DI. Materials and Methods: Using the Global Burden of Disease database (2016), the number of dental caries in permanent dentition, periodontal diseases, and edentulism was obtained. Empirical assumptions of patients with anodontia in urban and rural areas who opted for DI, percentage of implants placed, the affordability factors, and mathematical models for DI were formed and executed. Peri-implantitis and survival data from literary evidence were collated. Results: Based on assumptions, 909,643 Indians, (830,231–858,703) would choose DI. Estimated number of peri-implantitis would be 145,543–254,700 and estimated number of failures should be 50,940–79,412 in the near future. Conclusions: In spite of the high economic challenge and the risks or complications of peri-implantitis, DIs are gaining prominence. It is the dentists' burden to face the renewed challenges due to emerge and provide remedial measures.

Fracaso implantario derivado de la práctica del submarinismo: a propósito de un caso / Implant failure secondary to Scuba diving: report of a case

En las últimas décadas, el buceo con equipo de respiración subacuático autónomo (SCUBA) ha experimentado un gran auge, lo que conlleva la necesidad por parte del odontólogo de conocer las posibles complicacionesasociadas. Durante su práctica, se producen cambios en la presión inducida, así como micromovimientos derivados de sostener la boquilla del tubo de oxígeno con la boca, que pueden conducir al fracaso temprano del implante. El tiempo mínimo recomendado antes de volvera practicar el submarinismo tras la inserción de implantes dentales depende del criterio del cirujano; sin embargo, no se recomienda que seaantes de las primeras cinco semanas a dos meses postquirúrgicos. Encirugías con procedimientos asociados más complejos, se recomiendan periodos de reposo más largos.

In the last decades, the number of people who practice self-contained underwater breathing apparatus (SCUBA) diving has increased,which makes it important for dentists to be prepared to address andtreat complications resulting from its practice. While performing the sport, pressure may change and induced micro-motion derived from holding the tube of oxygen can lead to an early implant failure. Divingis not recommended during the fi rst fi ve weeks to two months after the implant placement. In surgeries where the associated procedures aremore complex, a greater recovery period is recommended.

Management of a failed femoral plate in an obese patient: A case report

Femoral nailing is the overall “gold standard” in treating femoral shaft fractures. However, plate osteosynthesis at the femoral shaft is still being done in selected patients. We report a case of right femoral implant failure after a broad limited contact dynamic compression plate (LC-DCP) insertion and its subsequent management using our minimally invasive technique. Our technique is biologically compliant as well as cosmetically friendly. We converted a loadbearing implant into a load-sharing implant in view that obesity is a significant predictive factor of non-union in a femoral fracture treated with locking plate. The patient subsequently recovered well with no complication.

Influence of the connection design and titanium grades of the implant complex on resistance under static loading

PURPOSE: The purpose of this study was to evaluate the resistance to deformation under static overloading by measuring yield and fracture strength, and to analyze the failure characteristics of implant assemblies made of different titanium grades and connections. MATERIALS AND METHODS: Six groups of implant assemblies were fabricated according to ISO 14801 (n=10). These consisted of the combinations of 3 platform connections (external, internal, and morse tapered) and 2 materials (titanium grade 2 and titanium grade 4). Yield strength and fracture strength were evaluated with a computer-controlled Universal Testing Machine, and failed implant assemblies were classified and analyzed by optical microscopy. The data were analyzed using the One-way analysis of variance (ANOVA) and Student's t-test with the level of significance at P=.05. RESULTS: The group IT4S had the significantly highest values and group IT2 the lowest, for both yield strength and fracture strength. Groups IT4N and ET4 had similar yield and fracture strengths despite having different connection designs. Group MT2 and group IT2 had significant differences in yield and fracture strength although they were made by the same material as titanium grade 2. The implant system of the similar fixture-abutment interfaces and the same materials showed the similar characteristics of deformation. CONCLUSION: A longer internal connection and titanium grade 4 of the implant system is advantageous for static overloading condition. However, it is not only the connection design that affects the stability. The strength of the titanium grade as material is also important since it affects the implant stability. When using the implant system made of titanium grade 2, a larger diameter fixture should be selected in order to provide enough strength to withstand overloading.

A conversion to implant overdenture in failed fixed implant prosthesis of edentulous maxilla: A case report / 대한치과보철학회지

Fixed implant prosthesis and removable implant overdenture are the main treatment options for treating edentulous maxilla with implants. If clinicians select one of the treatment options without accurate diagnosis and evaluation, this may lead to unfavorable treatment result and one would not be able to guarantee successful long term prognosis. In this case, 69 year-old female presented with failed fixed implant prosthesis that was treated in private dental clinic. Since the patient did not want additional insertion of implants and considering factors such as oral hygiene maintenance, splinting effect, and esthetics, the patient was treated with removable implant bar type overdenture using pre-existing implants. The clinical results were satisfactory in the aspect of esthetics and masticatory function, oral hygiene maintenance.

Gram-negative enteric rods associated to early implant failure and peri-implantitis: case report and systematic literature review / Bacilos entéricos gram-negativos asociados a fracaso temprano de implantes y peri-implantitis: reporte de un caso y revisión sistemática de literatura

The microbiota associated with failed implants includes Pseudomonas and Gram-negative enteric rods. The present study reports a case of Escherichia coli associated to early implant failed that was resistant in vitro to doxycycline, amoxicillin, metronidazole, and clindamycin, but was susceptible in vitro to ciprofloxacin and aminoglycosides. The literature concerning the prevalence of the opportunistic microorganisms in early implant failure and peri-implantitis patients, and the usual treatment of these patients harboring Pseudomonas and enteric rods was also revised.

La microbiota asociada con los implantes fallidos incluye Pseudomonas y bacilos entéricos Gram-negativos. En el presente estudio se informa acerca de un caso de Escherichia coli asociada a un fallo temprano del implante resistente in vitro a la doxiciclina, amoxicilina, metronidazol y clindamicina, pero susceptible in vitro a ciprofloxacina y aminoglucósidos. Se realizó una revisión de la literatura sobre la prevalencia de los microorganismos oportunistas en pacientes con insuficiencia temprana del implante y periimplantitis, y el tratamiento habitual de estos pacientes portadores de Pseudomonas y bacilos entéricos.

Insertion Torque of Mini Dental Implants and their Failure Risk after Immediate Loading / Torque de Inserción de Mini Implantes Dentales y su Riesgo de Fracaso cuando son Cargados Inmediatamente

A minimum insertion torque has been suggested for immediate function of regular diameter implants. Even when there is a growing tendency to use Mini Dental Implants (MDIs) for immediate function of dentures, there is no clinical data concerning MDIs insertion torque, nor its influence on implant failure. The aim of this prospective study was to assess the insertion torque of immediate loaded MDIs in edentulous patients and its association with risk failure. Ninety MDIs were placed in the anterior mandible of 45 edentulous patients, two per patient. The insertion torque was recorded with an electronic device and failures were documented during two years follow-up. All implants were immediately loaded with overdentures, using ball (44/90) or bar (46/90) attachments. A Kaplan­Meier survival probability estimator and a fitted multiple Cox regression model were performed to establish the influence of insertion torque and other clinical parameters on implant risk failure. The average insertion torque of 90 MDIs was 12.5±7.8 Ncm. A cumulative survival rate of 94.2% (5/90) was found by means of the Kaplan-Meier estimation. The Cox proportional-hazards regression model showed no association between insertion torque and MDIs failure. MDIs have much lower insertion torque than average conventional implants. The insertion torque of MDIs immediately loaded with mandibular dentures, seems not to be a risk factor associated to failure, at two years follow-up.

Un mínimo torque de inserción ha sido sugerido para realizar carga inmediata de implantes de diámetro regular. Aún cuando existe una tendencia creciente a utilizar Mini Implantes Dentales (MID) para la función inmediata de las prótesis totales, no hay datos clínicos relativos a los valores de torque de inserción de estos, ni tampoco de su influencia en el fracaso del implante. El objetivo de este estudio prospectivo fue evaluar el torque de inserción de mini implantes dentales con carga inmediata en pacientes desdentados y su asociación con el riesgo de fracaso. Noventa MIDs fueron colocados en la mandíbula anterior de 45 pacientes desdentados, dos por paciente. El torque de inserción fue obtenido con un dispositivo electrónico y los fracasos fueron documentadas a dos años de seguimiento. Todos los implantes fueron cargados inmediatamente con sobredentaduras, usando un sistema de retención de bola (44/90) o barra (46/90). Se utilizó el estimador de probabilidad de sobrevida de Kaplan-Meier y el modelo riesgos proporcionales de Cox ajustado para establecer la influencia de torque de inserción y otros parámetros clínicos sobre el riesgo de fracaso del implante. El promedio de torque de inserción de 90 MIDs fue 12,5±7,8 Ncm . Los MIDs mostraron a través de la estimación de Kaplan-Meier, una tasa de supervivencia acumulada de 94,2% (5/90). El modelo de riesgos proporcionales de Cox reveló que no existe asociación entre el valor de torque de inserción y el fracaso MIDs. MIDs tienen un valor de torque de inserción mucho más bajo que los implantes convencionales. El torque de inserción de MIDs cargados inmediatamente con prótesis mandibulares, no parece ser un factor de riesgo asociado al fracaso, a dos años de seguimiento.

Three-dimensional image contribution for evaluation of operative procedural errors in endodontic therapy and dental implants

Acceptable therapeutic protocol in dentistry depends on the outcomes obtained with follow up. Operative procedural errors (OPE) may occur and they represent risk factors able to compromise a tooth or a dental implant. The aim of this study was to detect the OPE in endodontically treated teeth and dental implants, using cone beam computed tomography (CBCT).Eight hundred and sixteen CBCT exams were performed between January 2009 and October 2010, and only those which presented endodontically treated teeth and/or dental implants were selected. The sample was as follows: 195 CBCT exams (n=200 teeth and 200 dental implants), 72 male, 123 female, with mean age of 51 years.In endodontically treated teeth, OPE included underfilling, overfilling, and root perforation; OPEin dental implants were thread exposures, contact with anatomical structures, and contact with adjacent teeth. Kolmogorov-Smirnov test was used for statistical analysis, with significance level set at α=0.05. Underfilling, overfilling, and root perforations were detected in 33.5%, 8% and 4.5% of the teeth, respectively. Dental implants with thread exposures, contact with important anatomical structures and contact with adjacent teeth were seen in 37.5%, 13% and 6.5% of the cases, respectively. OPE were detected in endodontically treated teeth and dental implants, and underfilling and thread exposures were the most frequent occurrences, respectively.

Protocolos terapêuticos aceitáveis em odontologia dependem de resultados observados com a proservação. Erros de procedimentos operatórios podem ocorrer e representam fatores de risco capazes de comprometer um dente ou um implante dentário. O objetivo deste artigo é detectar os erros de procedimentos operatórios em dentes tratados endodonticamente e implantes dentários por meio de tomografia computadorizada de feixe cônico. Oitocentos e dezesseis (816) exames tomográficos foram realizados entre Janeiro de 2009 e Outubro de 2010, e apenas aqueles que apresentaram dentes tratados endodonticamente e/ou implantes dentários foram selecionados. A amostra final envolveu 195 exames tomográficos (n=200 dentes e 200 implantes dentários), 72 do gênero masculino, 123 do gênero feminino, com idade média de 51 anos. Em dentes tratados endodonticamente os erros de procedimentos operatórios incluídos foram: subobturação, sobreobturação, e perfuração radicular; enquanto que, para implantes dentários foram incluídos: roscas de implantes expostas, implantes em contato com estruturas anatômicas, e em contato com dentes adjacentes. O nível de significância foi estabelecido em α=5%. Subobturações, sobreobturações e perfurações radiculares foram detectadas em 33,5%, 8% e 4,5%, respectivamente. Implantes dentários com roscas expostas, em contato com estruturas anatômicas, e em contato com dentes adjacentes apresentaram valores de 37,5%, 13% e 6,5%, respectivamente. Erros de procedimentos operatórios foram detectados em dentes tratados endodonticamente e implantes dentários. Os erros mais frequentes foram subobturação em dentes tratados endodonticamente, e roscas expostas em implantes dentários.

Early dental implant failure in patient associated with oral bisphosphonates.

Oral bisphosphonates are routinely prescribed to post menopausal women. These have shown to increase the risk of osteonecrosis. However, this action may be augmented by local factors. A case report is presented showing an early implant failure in a patient taking oral bisphosphonates. Two implants were placed in left maxillary incisor area. Central incisor was associated with a previous endodontic failure and extraction. Lateral incisor was avulsed 3 years back. After 4 weeks of an implant placement, necrotic bone was evident along with the failing implant in central incisor area. This case report emphasizes on the incidence and an increased risk of implant failure in patients taking oral bisphosphonates.

Estudo retrospectivo da relação entre o tempo de carga protética e a perda tardia dos implantes / The relationship between prosthetic loading time period and late dental implant failure: a retrospective study

Este estudo retrospectivo teve como objetivo avaliar a relação entre a perda tardia dos implantes com o tempo de carga protética, realizados na Faculdade de Odontologia de Piracicaba durante o período de 11 anos. Para isso, foram selecionados 875 prontuários de pacientes submetidos a tratamento com implantes e prótese sobreimplantes durante um período de 11 anos, totalizando 939 implantes. Dos 55 implantes que foram perdidos após a reabilitação concluída e sob função, fez-se a análise do tempo entre a instalação da prótese e o momento do fracasso da reabilitação. A análise estatística utilizada foi a do teste t para amostras independentes (com o valor p < 0,05) e posterior modelo de regressão logística binomial, a fim de quantificar os resultados encontrados. Como resultado, foi observada influência estatisticamente significante entre a perda tardia dos implantes com o tempo da reabilitação em função (valor p = 0,000), apresentando risco de perda 0,7 vezes menor a cada mês (probabilidade = 0,7). Com este estudo, concluiu-se que a perda tardia dos implantes é maior nos primeiros meses da reabilitação e após o primeiro ano, a chance de fracasso diminui consideravelmente

This retrospective study evaluated the association between late implant failure and prosthetic loading moment at the Piracicaba Dental School for an 11-year period. For this, 875 charts of patients treated with implant-supported prostheses (n=939 implants) were selected. The Student´s t test for independent samples (p<0.05) and binomial logistic regression model (odds ratio) were used to analyze time between prosthesis function and failure. Fifty-five implants were lost in function. Statistically significant influences were observed between late implant loss over time in function (p = 0.000), with the risk being 0.7 times lesser each month. This study concluded that late implant failure is higher in the first months, and after the first year, the chance of failure is significantly reduced.

Relación entre el exito y fracaso en los procedimientos implantológicos: análisis retrospectivo de 06 años / Relationship between success and failure in implant procedures: a retrospective analysis of 06 years

Los implantes dentales oseintegrados son actualmente una opción de tratamiento segura e previsible para la rehabilitación de pacientes desdentados. De esta manera el objetivo del presente estudio fue evaluar retrospectivamente el índice de éxito y fracaso de los implantes oseointegrados instalados por el Área de Cirugía y Traumatología Bucomaxilofacial de la Facultad de Odontología de Piracicaba de la Universidad Estatal de Campinas (FOP-UNICAMP) en el período de Junio del 2001 hasta Julio del 2007. Durante este período fueron encontrados 1,800 historias clínicas de pacientes tratados con implantes, siendo que de estos fueron seleccionados 492 que cumplían los criterios de inclusión-exclusión establecidos. Los resultados muestran que el índice de fracaso fue de 10,6% siendo que en 6,3 % de los casos hubo pérdida primaria y en 4,3% hubo pérdida tardía; mientras que el índice de éxito fue del 89,4%. En conclusión, se observa que los resultados encontrados se encuentran próximos de los padrones normales relatados en la literatura

The osseointegraveis dental implantations are currently an option of safe and previsible treatment for the whitewashing of edentate patients. Being thus, the objective of the present study is retrospectively to evaluate the index of success and failure of the osseointegraveis implantations installed by the area of Buco-Maxilo-Face Surgery of the Fop/Unicamp in the period of June of 2001 the July of 2007. During this period they had been found a total of 1.800 handbooks of patients dealt with implantations, being that of these 492 had been selected that they fulfilled to the criteria of established inclusion/exclusion. The results show that the failure index was of 10,6%, being that in 6,3% of the cases it had primary loss and in 4,3% had delayed loss; whereas the success index was of 89,4%. In conclusion, it is observed that the joined results are next to the normal standards told by literature

The effects of local factors on the survival of dental implants: A 19 year retrospective study / 대한치과보철학회지

PURPOSE: The aim of this retrospective study was to provide long-term data about the correlation between multifactorial local factors and the survival of implants. MATERIAL AND METHODS: During 19 years (1991 to 2009), 2796 implants were placed in 879 patients. From dental charts and radiographs, the following data were collected: patient's age at implant placement, gender, implant system, surface, length, diameter, location of implant placement, bone quality, primary stability, type of prosthesis. The correlations between these data and implant survival were analyzed. Statistical analysis was performed using Kaplan-Meier survival analysis, Chi-square test, odds ratio. RESULTS: 1. Among the 2796 implants, 150 implants failed that resulted in a cumulative survival rate of 94.64%. The cumulative survival rate of smooth surface implants (91.76%) was lower than rough surface implants (96.02%). 2. Anatomic location, implant surface, diameter of smooth surface implant, primary stability, type of prosthesis, patient's age and gender were significantly associated with implant survival (P < .05). 3. No significant difference in implant survival was found in relation to the following factors: implant length, bone quality, diameter of rough surface implants and type of rough surface according to implant manufacturer (P < .05). CONCLUSION: Local factors such as anatomic location, implant surface, diameter of smooth surface implant, primary stability and type of prosthesis have a significant effect on implant survival.

Analysis on cause of failure of guided bone regeneration during implant placement: A retrospective study / 대한치주과학회지

PURPOSE: The aim of this retrospective study is to evaluate survival rate of implant and bone formation, to analyze failure contribution factor. MATERIAL AND METHODS: A total of 52 consecutive patients(35 male, 17 female, mean age 49 years) with 104 osseous defects were treated during the period from October 2004 to June 2007 with a simultaneous or staged GBR approach using non-resorbable or resorbable membranes combined with autogenous bone grafts or xenograft(Bio-Oss, Bio-cera, BBP). RESULT: A total of 32(30.8%) of 104 GBR-treated sites failed the bone formation and a total of 5(5.6%) of 89 implants were removed. Early exposure of the membrane has significantly affected bone formation(p<0.05). Non-resorbable membrane showed more exposure of the membrane and low success rate of bone formation than resorbable membrane(p<0.05). There were no difference between success rate of bone formation and using autogenous bone or graft materials. There were no statistically significant difference between success rate of bone formation and smoking or using PRP. Mandible showed more success rate of bone formation than maxilla(p<0.05). CONCLUSION: Early exposure of the membrane, membrane type and maxilla/mandible type have influence on success rate of bone formation during GBR.

Survival rate of implant placement in the maxilla treated with sinus elevation by the lateral approach: A retrospective study / 대한치주과학회지

PURPOSE: Osseointegration of implants in patients with pneumatized maxillary sinuses is difficult to achieve due to the deficiency of available bone in the posterior maxilla after loss of teeth. Maxillary sinus elevation is a method to overcome this problem. In this study, we evaluated the implant survival rate and the relationship between implant survival in patients with sinus elevation by the lateral approach. MATERIALS AND METHODS: A total of 48 patients were consecutively treated with sinus elevation by the lateral approach between February 2003 & August 2006 at the dental hospital of Chonbuk National university. A total of 113 implants were placed. The mean healing period was 7.1 months and implants were placed after a mean period of 5.6 months. The mean observation period was 21.8 months. RESULTS: Out of the 113 implants placed, fifteen failed, resulting in a survival rate of 86.7%, 18 cases of sinus membrane perforation were observed out of 65 sinuses treated. 33 implants were placed in a perforated site and 10 failed, representing a 60.7% implant survival. 80 implants were placed in a nonperforated site and 5 failed, representing a 92.6% implant survival. CONCLUSIONS: Implant placement with sinus elevation is an acceptable treatment for short term Results. Sinus membrane perforation and postoperative complications, however, may have an effect on implant failure.

Long-term Follow-up Results of Short-segment Posterior Screw Fixation for Thoracolumbar Burst Fractures

OBJECTIVE: Despite general agreement on the goals of surgical treatment in thoracolumbar burst fractures, considerable controversy exists regarding the choice of operative techniques. This study is to evaluate the efficacy of short-segment fixation for thoracolumbar burst fractures after long-term follow-up and to analyze the causes of treatment failures. METHODS: 48 out of 60 patients who underwent short-segment fixation for thoracolumbar burst fractures between January 1999 and October 2002 were enrolled in this study. Their neurological status, radiological images, and hospital records were retrospectively reviewed. Simple radiographs were evaluated to calculate kyphotic angles and percentages of anterior body compression (%ABC). RESULTS: The average kyphotic angles were 20.0degrees preoperatively, 9.6degrees postoperatively, and 13.1degrees at the latest follow-up. The average %ABC were 47.3% preoperatively, 31.2% postoperatively, and 33.3% at the latest follow-up. The treatment failure, defined as correction loss by 10?or more or implant failure, was detected in 6 patients (12.5%). 5 out of 6 patients had implant failures. 2 out of 5 patients were related with osteoporosis, and the other 2 were related with poor compliance of spinal bracing. 3 patients with poor initial postoperative alignment had implant failure. 4 patients with screws only on the adjacent vertebrae and not on the injured vertebra itself showed poor initial and overall correction. CONCLUSION: With proper patient selection, adequate intraoperative reduction with screw fixation involving the injured vertebra, and strict postoperative spinal bracing, the short-segment fixation is an efficient and safe method in the treatment of thoracolumbar burst fracture.