Possible Complications of Dental Implant Treatment

By Brian J. Gray, DDS, MAGD, FICOI

The endosseous system of dental implants, currently the most popular system used, has been utilized to replace missing teeth for over thirty years. Dental implants are very successful. Implants are made of titanium, an inert metal that bonds with the bone and forms a very tight union. Implants have a 90% to 95% success rate and once placed and restored, can last for an indefinite amount of time.

Although rare, implants do fail. If the bond between the implant and the bone breaks, or the implant itself breaks, it may have to be removed. If so, it may be possible to replace the failed implant, either at the same time or after doing a bone grafting procedure.

There are two main reasons why implants fail:

1. Infection of the implant surface can result in disintegration of the bond between the implant and the bone. Eventually, the implant may have to be removed. To avoid infection at the time of implant placement, sterile operating techniques are recommended and most implant surgeons prescribe antibiotics after surgical implant placement.

   The oral bacteria that cause periodontal disease can also affect implants. Around implants, this infection is called peri-implantitis. Just as with the natural teeth, meticulous oral hygiene that includes brushing and flossing, combined with periodic professional cleanings are critical to prevent peri-implantitis.

2. Excessive loading: If the forces on the implants are too strong or not in the right direction, the implant components can break or the bond between the implant and the bone can disintegrate. The bite on an implant has to be properly designed.

There are certain risk factors that may increase the risk of implant failure. Smoking, for example, halves the success rate of implants and is the number one risk factor for implant failure. Also, persons that have a diminished healing ability such as people with uncontrolled diabetes may have an increase risk for implant failure. To reduce the risk of implant failure, and to prevent serious health complications from surgery, a thorough medical evaluation is required before dental implant treatment.

To reduce the risk of implant failure, make sure that the dentist that places the implants and the one that restores the crown on the implant have plenty of experience with implant procedures. The success of implant treatment is dependent on the expertise of the dental team and the patient's ability to control plaque. With proper implant design and follow-up maintenance, you could enjoy the benefits of dental implant treatment for a lifetime.