As with any treatment, dental implants problems can and do develop sometimes. But before we discuss these problems, it is important to note that in general, implants have a very high success rate. Developing complications with the treatment is therefore rare, much rarer than the procedure being a great success!
Any problems that do arise with implants are usually related to one or more of these associated risk factors:
- Improper treatment planning, incorrect placement or using them when not suitable (e.g. not enough healthy bone to hold them in place)
- Smoking – a major cause of problems with teeth implants. If you want these to last then you really need to stop smoking!
- Fracture of the titanium screw or crown/bridge denture that it holds in place.
- Dental implant failure (rejection), i.e. the metal does not fuse with the bone tissue, or does fuse but is then is rejected later.
- Complications of implant surgery. Any surgical procedure carries some risks, and this treatment is no different. The risk varies with the number of screws to be placed, local anatomical factors, your general health and types of implant to be placed (amongst other factors). Such complications are usually mild and short -term, such as pain, swelling and bruising. Longer terms risks include nerve damage and bone infection. Your dentist/oral surgeon will discuss these in detail (as part of the pros and cons of the treatment plan) before undergoing the procedure.
Signs of failure to watch out for include:
- Loosening of the ‘false tooth/teeth’ that are held in place (eg crown/bridge/dentures)
- Inflammation (swelling/redness/bleeding) of the surrounding gum
- Bad taste or smell
- Pain from the area.
Let’s look at the common problems in more detail:
Dental Implant Failure
As the name implies, this is a general term for when implants do not set into place properly and are rejected by the bone. Failure causes include:
- Infection. If bacterial contamination occurs around the implant, then the metal surface will not integrate with the bone properly. Likewise, even if it h
as already fused to the bone, if infection sets in this can break the bond between the titanium surface and the bone tissue. Proper oral hygiene is vital at all times, but especially in the early stages when the screw is first placed. ‘Peri-implantitis’ is infection around the outer metal surface. Smoking leads to much higher failure rates.
- Overloading. Implants that are exposed to excessive forces are likely to fail. Such forces may be a result of grinding/clenching habits, improper positioning of the screw (and hence exposure to destructive jaw forces) or the titanium being ‘restored’ too early (ie the crown or bridge set in place before the implant has healed properly).
- Bone problems. Examples here include bone graft rejection, poor blood supply to the area or development of a bone disease/side effects of a drug.
- Poor choice of implant type. If the screw is too short or narrow for example, it may be more prone to failure. This is why proper planning is so important with this treatment.
In the same way that they can be rejected if they are overloaded, implants can fracture under undue stress. They are therefore more likely to fracture if incorrectly placed and/or if you clench/grind your teeth.
Should a fracture occur, it will need to be replaced. The broken screw is removed, a slightly broader one placed and then left to heal as before.
The restoration (crown, bridge or denture) overlying the metal part may also fracture or come loose. This is not as big a problem, as these are easier to replace than the screw itself.
In some instances, the appearance of the gum tissue that surrounds false tooth/teeth is not ideal. This may range from a flattened gum appearance to very thin gum (so the metal margins are visible). A gum graft may be needed to resolve the issue.
With severe gum disease the gum may erode away entirely, showing the metal underneath.
Treating Dental Implant Problems
Depending on the specific problem, the treatment needed may be:
- Replacement of the work may be the only failure treatment. Whatever caused the failure in the first place must be dealt with to prevent recurrence.
- Bone graft. If there is minor bone loss around the metal, a repair with bone grafts may be enough.
- Gum graft. If a problem occurs that is due only to the gum tissues (i.e. the bone is OK) then a gingival graft to replace the missing tissue may be needed.
- Removing the implant and placing a denture/bridge. If circumstances dictate, replacing those that have failed may not be suitable. For example, development of a bone disease, continued heavy smoking, severe gum disease leading to major bone loss.
So as you see, there is a range of potential dental implants problems. Many of these are avoidable with proper planning and good home-care of the treatment. But again note that this treatment has a very high rate of success on the whole.