Are Dental Implants safe?

Yes, the success rate for dental implants is more than 95%.  If problems occur, it is usually minor problems which can be resolved.  Unfortunately, as with any surgery or other dental procedures, there are certain risks and possible complications.  Please keep in mind that these problems are rare, especially if the treatment is performed by a well qualified and experienced dentist / dental specialist.  It is also important that the patient will accept some responsibility by maintaining good oral hygiene and visiting the dentist regularly.  Smoking can decrease the success rate considerably and some dentist even refuse to do implants for smokers – so if you are a smoker and need dental implants, I would suggest that you use this as an incentive to stop smoking.

Dental Implant Problems – Risks and Complications

Peri-Implantitis

Peri-Implantitis is a fancy word for infection around the implant.  This is one of the most common complications. The patient presents with inflammation of the tissue around the implant. If it is left without sufficient treatment, the patient will get bone-loss around the implant until the implant fails and needs removal.  The reason for peri-implantitis is bacteria, often because of poor oral hygiene and plaque build-up around the implant.  Peri-implantitis is especially problematic in patients with poor oral hygiene, diabetes and smokers.

Osseointegration failure

Ossiointegratin is the formation of a connection between the implant and the patient’s bone.  This is extremely important as osseointegration is required to keep the implant tight, in place and functioning properly.  It is a process that takes place over several months.  If Osseointegration doesn’t take place, bone-loss will be seen around the implant or the implant will be mobile or even fall out.

Causes of failed Osseointegration

• Insufficient bone: If the bone density is low or the width, length or height of the bone is insufficient, osseointegration may not happen. In order to prevent this, it may be necessary to get bone grafts first, in order to increase the bone and chances of success.
• Damage to tissue surrounding the implant
• Overloading of the implant. The dentist will need to do careful assessment and treatment planning before placing the implants to ensure that the implants will not be overloaded.
• Fractured implants
• Trauma causing a sudden impact or high external force on the implant.
• Incorrect positioning of the implant.

Nerve damage

As with any invasive surgery, some tissue damage can be expected. Pain and bleeding shortly after implant surgery is normal, however, if the pain/ bleeding doesn’t go away after a few days and seems excessive, you must see your dentist.  Apart from the ‘normal’ tissue damage, it is possible that a nerve can be damaged during implant placement or that an implant is too close to a nerve causing symptoms like numbness in the gums, cheek, lips or tongue.  It may also present as a tingling sensation or chronic pain.  The implant will need to be removed if this happens.  Although it is possible that the nerve will recover over time, the damage may be permanent.

Sinus Problems due to Dental Implants

There are often little space and bone present in the upper jaw for implant placement due to the presence of the sinuses.  If a surgeon doesn’t take care, it is possible that the implant can protrude into the sinus which will cause pain and infection/ inflammation in that area.  Fortunately this is not a common occurrence but if you do get sinus related problems after implant placement, it should be investigated.

If there seems to be an issue with too little space to place the implants due to the sinuses, the surgeon will consider performing a procedure where the sinus floor is lifted and bone grafting done first.

Failure of the Implant itself

Implants are made from very strong metal and it is uncommon for them to bend or fracture, but it can happen.  This can be due to trauma to that area with sudden high forces on the implant.  Implants can also fail over time due to constant trauma due constant high biting forces on it, for instance with people who tend to grind on their teeth (bruxsate).  Careful case selection and treatment planning can usually avoid this complication.

Allergy to Implant and Foreign Body Rejection

Although rare, a patient’s body can see the implant as something foreign and reject it.  There is also the possibility of allergy to the titanium (which is usually used for implants.)  The patient may experience inflammation in the area of the implant or even symptoms like chronic fatigue syndrome.  If an allergy is suspected, Cosmetic Dentistry Advisor suggest an allergy test to confirm whether the reaction is in fact due to an allergy, or perhaps caused by something else.

Overloading

Overloading is when failure is due to forces or pressure placed on the implant / implant crown which are too high.  This is especially a potential problem in immediate loading cases where the crown is placed on the implant directly after the surgery.  It means that there are forces placed on the implant before osseointegration has taken place.

How to Prevent Implant Failure

It is not always possible to prevent complications and failure, but the risk can be limited.

The patient need to ensure that he/she picks an experienced and suitably trained oral surgeon or dentist to provide the treatment. Ask for recommendations, and if you feel unsure about your dentists, feel free to go and see someone you feel more comfortable with.

The dentist should carefully consider whether it is advisable to do implants for patients with uncontrolled diabetes or who smokes, use bisphosphonates or grind their teeth.

It is also extremely important that the patient maintains good oral hygiene. Any problems in this regard must be addressed first.  If there is not sufficient bone or the primary nerve in the lower jaw cannot be located, implants may also be contra-indicated.

If you are one of the unlucky people who encounters problems with an implant, make sure you seek help as soon as possible as it may be possible to save the implant.  If the implant cannot be saved, it will need removal.  After healing a new implant can be placed, provided that the reason for the first failure has been addressed and steps have been taken to prevent future failure.