Dental implant failure or complications
Here at Seapoint, we are regularly referred cases from other dentist where things are not going to plan. As we focus on complicated cases and have the skills and expertise to fix almost any problem, we are happy to accept dental implant cases from anywhere in the world, if they are failing.
Unfortunately nothing in life is 100% successful and dental implants are included in that. Typically, dental implants have a success rate of 90-98% which in medical terms is incredibly high. At Seapoint, we have a particularly high success rate as we carefully plan each case to increase successes. In spite of this there is no dentist who can guarantee success as so much of the success depends on each person`s healing capacity and general health.
In terms of failures, these can occur early, during the healing process or, later after the teeth are made and they are being used. Early failures are frustrating but easier to understand as the bone didn`t bond to the implant properly or the area got infected. The later complications can be more distressing, as they happen after the final teeth are made and can end up losing these teeth you have become used to.
Main Causes of Implant Failure
Infection – This can happen in particular if you have poor immunity or a lot of bacteria in the mouth. The better the area is cleaned after implant placement the less likely you are to have a problem. Sometimes if an infection is picked up early it can be treated without removal of the implant so if you notice any bad taste or smell after the first week let your dentist know immediately.
Overheating of the bone – Some clinics do not use adequate cooling during preparation of the implant site. At Seapoint we use chilled saline to reduce the risk and our dentists are all extremely experienced.
Bad Quality Bone – Everyone`s bone is different and it can vary widely even in the same patients jaws. At Seapoint we take detailed CT scans to check the bone as thoroughly as we can before placing an implant. Even with the latest technology it is only when the implant is being placed that the bone can be fully assessed. Many dentists do not have a CT scanner onsite and so are much more likely to end up placing an implant in an area of poor bone quality or being unable to place an implant at the time of surgery. Some people have bone which is as hard as concrete and others have bone softer than foam which can make a big difference to successes.
Blood Supply – If your bone has a bad blood supply it is difficult for healing to occur properly or at all. If you had radiation therapy to an area the blood supply can be permanently damaged. Some medications such as bisphosphates can also reduce the healing in an area. Smokers typically do not heal as well as non-smokers and so we recommend stopping smoking 2 weeks before surgery to improve success rates.
Habits – Some people have a tongue thrust or bite their nails etc which can put excessive pressure on a healing implant. During healing the bone is softer than at the time of placement and so too much pressure can cause microfractures of the healing bone leading to the bone not fusing to the implant. Smoking etc is also a big problem with the failure rate twice as high in smokers as non smokers.
Long Term Failures:
Once the teeth are made failures can still occur primarily due to excessive forces and also infection occurring.
Overload – Dental implants are not as good as your own healthy tooth but they are the closest thing we can provide. Your own teeth have a ligament around them which acts like a shock absorber when you chew too hard. You also have nerves around the teeth that tell you when you are biting too hard on something. Dental implants do not have these things. They are rigid in bone and you can`t tell too easily if you are biting too much. That means it is easier to overload the implants than regular teeth. That can cause small fractures in the bone which over time leads to the implant becoming loose.
Some people develop grinding habits over time and a dental implant that was originally not too heavy in the bite can become too heavy in the bite leading to failure. Every time you lose a tooth you are putting more pressure on the remaining teeth/implants which can lead to failure.
At Seapoint we design your plan carefully to try to reduce the chance of long term failures. We place as many implants as possible so reduce the stress on each one. We typically fuse the crowns together so that the implants are sharing the loading forces. We also choose high quality, well researched dental implants which are likely to last.
Infection – Some people are genetically more prone to gum problems and to gum disease. Dental implants can be affected just like teeth by these bacterial infections. In a small number of people the gum and bone can recede away from the implants over time which can lead to failure. There is at present no definitive way of determining who this is likely to happen to but it is generally a rare event. Unfortunately if you are the person it happens to it can be very upsetting.
What can be done if an implant is lost?
If you lose a dental implant early on during healing it is often possible to replace it with success the second time around. Again there are no guarantees but having one failure doesn`t mean you cannot get a dental implant again. It will be up to you as the patient to decide if you are happy to go ahead or if you would prefer an alternative. Sometimes if we have enough dental implants in the area we may decide it is possible to go ahead with the final teeth using the other implants instead of replacing the failed one. That is a matter for discussion with the treating dentist as all cases are different.
If implant failures occur later after the teeth have been made it can be a more complicated situation. Where there is a full jaw of implants present it is usually possible to remove the problem implant and leave the teeth in place on fewer implants. Where there is a single dental implant holding a tooth it will usually mean removal of the implant and the tooth. You will typically have to wear a temporary tooth of some kind before a new implant is placed if you decide to replace it with another implant. Some people would decide to get a bridge or a denture in this situation but again this is a personal decision.
If implants fail there can sometimes be damage to the bone and the gum in the area. This is more common if the area has been chronically infected and it is a reason you should always return immediately if you feel any problems, however small.
Eastern European/Hungarian Dentistry
We regularly see cases which were carried out inappropriately in Eastern Europe. Sometimes there have been too few implants placed to support the loads, other times the implant used is of poor quality and often it is impossible to properly clean around them due to the design. If there is a problem we will let you know and try to come to a solution. It doesn`t always mean everything needs to be removed and we will always work with you to achieve the best possible outcome for you.
Failures from other clinics- Sometimes the dentist who placed your implant(s) may not be adequately trained to deal with failures when they occur. For example if you have seen a general dentist who only occasionally places implants he may never have dealt with the problem before. In such cases we are happy to assist you and him/her to get you back to comfort and function. Just because we didn’t carry out the original treatment does not mean we cannot help you.