Importance of local and systemic factors in preventing implant displacement in the mandibular body: a scoping review of existing literature.

ABSTRACT

BACKGROUND: The aim of this research was to analyse the current literature on displaced dental implants in the mandibular body, including local and systemic variables related to their cause, and to identify the most frequent location. METHODS: The study conducted a search of three databases (Pubmed, Scopus, and Web of Science) using specific index terms such as 'dental implant', 'displacement', 'dislocation', 'displaced', and 'mandible'. The analysis focused on the direction of displacement and the characteristics of the bone tissue (bone quality, density, and quantity) in cases where dental implants were displaced. RESULTS: A total of 371 articles were obtained. Thirteen of these articles were selected and read in full. To define bone quality, the Lekholm and Zarb classification, modified by Rosas et al., was used. The type II-B bone, which is characterized by thick cortical bone surrounding cancellous bone with extremely wide medullary spaces, presented the largest number of complications. Twenty-two cases were found in which the displacement direction was horizontal. Of these, four were displaced vestibularly, fourteen lingually, and four remained in the center. Additionally, 24 cases presented vertical displacement, with 12 displaced towards the inferior border of the mandible, 9 towards the middle or adjacent to the inferior dental nerve canal, and 3 above the inferior dental nerve canal. CONCLUSION: The accidental displacement of implants within the mandibular body is associated with various risk factors, including the characteristics of the bony trabeculum and the size of the medullary spaces. It is reasonable to suggest that only an adequate pre-surgical diagnostic evaluation, with the help of high-resolution tomographic images that allow a previous evaluation of these structures, will help to have better control over the other factors, thus minimizing the risk of displacement.