Failed Dental Implants

A failed dental implant is an unusual situation, but it does occur. If that happens, there’s no need to panic as there are treatment options available. Sometimes the cause of failure is preventable too. Dental implants are usually a predictable and successful procedure, but it requires a great deal of training and experience to place correctly.

Osseointegration

Osseointegration is a biological process that allows a dental implant to function correctly by letting your body produce bone cells around the implant surface, surrounding it, and anchoring to your jaw bone. If osseointegration doesn’t happen the way it should, it can cause problems and after the dental implant is inserted and lead to a failed dental implant.

A failed dental implant often occurs if osseointegration doesn’t happen

Is my implant failing?

Mobility is often the first sign of a failing implant. This happens because the bone is not growing properly around the implant. Initially there might be only very little mobility recognizable by a dentist, but over time an implant that has failed to integrate will feel wobbly and may move when the person chews or talks. A totally failed implant will be consistently movable.

Other signs of an dental implant that has lost osseointegration may include pain, swelling or infection, but that’s not always the case. An X-ray of a failed implant will usually show the bone loss around the implant. So if we notice any mobility in the implant, we’ll do an X-ray to examine the bone growth.

Failed Dental Implant. Dental Implant Bone Loss

What causes a failed dental implant?

The success of an implant procedure depends on many factors, but certain habits and medical conditions can increase your risk of a wobbling implant. Gum disease and bruxism (Teeth Grinding) can damage a healing implant, while diseases like osteoporosis that attack bone strength and density can make it difficult for the implant screw to anchor. Ongoing cancer treatment may also be cause to pause an implant, since radiation therapy  can sometimes inhibit the bones’ ability to heal.

Some medications can also put you at risk for implant failure. According to the University at Buffalo, a compound in antidepressants that affects your rate of bone metabolism can cause osseointegration problems for people who take these medications.

Smoking may increase your risk of dental implant failure depending on where in your mouth the implant is placed.

Causes of Failed Dental Implants
  • Gum disease (Peri-Implantitis)
  • Bruxism (Teeth Grinding)
  • Osteoporosis
  • Cancer treatment/Radiation Therapy
  • Some medications
  • Smoking
  • Inadequate imaging
  • Incomplete medical Information
  • Substandard fixtures
  • Imprecisely placed implants

Types of Dental Implant Failure

In general, there are two categories of implant failures that are based on timing. We have “early failures” that occur within the first few months of the implant and “late failures” can be considered occurring a year or later after the tooth has been in function.

Early Dental Implant Failures

In these cases, the bone has not formed rigidly around the implant and the implants are usually very easy to remove. In many early failures, the implant is quite loose. This is often due to poor healing ability of the patient, infection, lack of stability when it was placed (not firm enough in the bone) or most likely micro motion (too much movement of the implant during the healing process).

Late Dental Implant Failures

In these cases, it is possible that the implant was firm and then gets loose. This may be due to infection or too much force on the implant. This occurs often with premature overloading of an implant where it spontaneously is rejected. This type of late failure is easy to remove much like the early failure.

In most other late failure cases, the implant is rigid but X-rays show a pattern of implant disease called “perio-implantitis”, where bacteria has developed and is destroying the bone around the neck of the implant. Perio-implantitis is a growing concern with dentists and patients because it represents an active infection with a dental implant. This infection manifests as sometimes with pain, plus, abscess and bad odor. Measures are required to stop this disease. Unfortunately in many cases, the implant should be removed to prevent spreading pain, infection and further bone loss.

Wrong Implant Position

Another reason your implant might need to be removed, if it’s in the wrong position, that’s considered a failure because there is trouble restoring the implant into proper function or esthetics. This is preventable with proper treatment and planning.

Infections, loose implants, nerve impairment, and puncture of other body cavities can result from dental implant failure. Imprecisely placed implants can leave room for persistent infections. If the implant is placed where there is not sufficient bone structure, or if the fixture is substandard, it can become loose. Without the use of 3D CT scanning technology, dental implants can easily interfere with nerves within the bone, causing numbness, tingling, and pain. And sometimes dental implants are so poorly placed that they actually puncture sinus cavities.

Peri-Implantitis

Peri-Implantitis causes tissue and bone loss ultimately leading to a failed dental implantPeri-Implantitis is a disease characterized by the inflammation of gum tissue and bone around dental implant resulting in the loss of the supporting bone around it. Often times you may not be aware that this is occurring and it is important to seek treatment for the condition if it is detected.

Symptoms of peri-implantitis can vary in type and severity. Some symptoms include redness inflammation and bleeding of the surrounding gum tissue, deepening of the periodontal pockets around the implant, exposure and visibility of the underlying implant threads, loosening of the implant itself, and poss discharging around the implant. In cases of more severe infection the lymph nodes on your neck may become swollen as well.

The most common cause of peri-implantitis is tartar buildup at the implant site which harbors toxin emitting bacteria that cause irritation of the surrounding gum tissue and ultimately results in tissue and bone loss. There are other possible causes that may apply depending on your situation.

If left untreated, the infection and bone loss can progress to a point that the implant does not respond to treatment and could lead to loss of the implant altogether. If addressed early enough, there are treatment options available to halt the progression of the disease and attempt to repair its damage. It is important to work closely with a doctor experienced in treating this condition to determine the best options with the highest likelihood of success.

Dental Implant Failure and the Diagnostic Phase

Dental implant failure can result from shortcuts taken during the diagnostic phase, from inadequate imaging, and from incomplete medical information. Taking and evaluating a complete medical history is essential because many medical conditions can affect dental implants.

Planning for dental implant placement is one of the most important parts of the process. A two-dimensional panographic x-ray is sufficient in the diagnostic and planning phase of many types of oral surgery. But it is important to use a 3D CT scanner to plan for the placement of dental implants. It allows our doctors to evaluate the quantity and quality of available bone structure, to visualize the shape and location of sinus cavities, and to see exactly where the blood vessels and nerves are within the bone.

Dental Implant Failure and Substandard Fixtures

There are many companies that make dental implant fixtures, but only a handful of them have published peer-reviewed research studies that document the quality of their fixtures. Because of this, substandard fixtures can cost as little as a hundredth of the cost of fully tested fixtures. Many dentists are tempted to increase their profit margins, but the consequences often lead to failure. We use only the highest-quality fixtures in our implant restorations.

Failed Dental Implant Treatment

A failed dental implant is easily removed with local anesthesia. If an implant needs to be replaced, they will take it out and gently clean the area. If the bone is intact around the area of the removed implant, no bone graft will be necessary.

If there is bone loss, we may place a bone graft to improve the site for replacing the implant. Healing from a bone graft can take several months before a new implant can be placed. During healing, we’ll discuss ways to reduce the risk factors that caused the implant to fail, such as quitting smoking or waiting for a course of cancer treatment to be finished.

Avoiding Complications and Preventing Dental Implant Failure

Prior to your implant placement, have a discussion with us about any risk factors that can limit the success of your implants. A change in your medical condition or medications can affect healing and osseointegration, so always inform your dentist or dental specialist of any changes to your health and medical history.

Good oral hygiene is also key to avoiding implant problems. Brushing twice daily and rinsing with an antibacterial mouthwash can help keep your gums healthy and bacteria at bay while your new tooth settles into place.

One of the most important consideration in preventing dental implant failure is the training and experience of the doctor you choose. Placing dental implants involves much more than is taught in dental schools. Therefore it is best to choose a practitioner who has invested the time and money in advanced postdoctoral continuing education in dental implants.

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Find out how you can avoid dental implant failure with Atlanta Periodontics.

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