Updated: Sep 10, 2020
Implants are taking over in the dental world. With the poor longevity and comfort of partial dentures and the inefficacy of cleaning methods for fixed partial dentures, more and more dentists are opting to place implants.
Implants help maintain the integrity and strength of the jaw. Once a tooth is removed, the bone in the socket and surrounding it becomes fragile. For this reason, implants are becoming a great option for the aging population. Implant cost has come down in the years and they are an amazing advancement for dentistry, but they come with their set of potential complications. Although uncommon, here are some things to think about:
Implants aren’t exactly real teeth. First, it’s a foreign object. Although materials are becoming increasingly biocompatible, your body still needs to accept this foreign object. Second, bone needs to embed into the implant threads. Third, implants do not possess the shock absorbers of our normal dentition (the periodontal ligament). This is why excessive pressure can lead to the implant failing.
Preface - an implant can be thought of as two parts – the part that goes into the bone which I refer to as the implant and the part that goes on top and is visible to you, which I’ll refer to as the crown. There are other components to implants but the technical complexity won’t add much to our discussion.
If an implant does not bind and integrate with bone, it will come loose. Poor technique, patient systemic complications, pressure overloading, infection or tissue damage are all be risk factors.
Some bone loss is expected within the first year of getting an implant, but it should not progress. Bone loss can be a sign of excessive pressure or infection. If little bone is left in an aesthetic zone, bone replacement or augmentation may be conducted before implant placement in order to create a uniform gum line.
As technology improves, this complication is becoming increasingly rare. Essentially, the implant can fracture somewhere around the crown and implant junction. Removal and re-implanting may be an option to fix this.
Excessive pressure on the crown may be the culprit, but trauma can also lead to this outcome. In this case, the dentist would just remake the restoration, if all other tissues are healthy.
This is the most common reason for implants to fail. Peri-mucositis is analogous to gingivitis - bleeding and inflammation around the pocket. Peri-implantitis is analogous to periodontitis - gingivitis symptoms and loss of bone. Smoking, genetics, diabetes and occlusal overload are all risk factors.
Bad aesthetics or function
If the crown is not shaped properly, it can create big spaces between teeth. Implants need to be cleaned just like regular teeth. If a lot of plaque builds up, it can lead to periodontal infection or even the decay of the adjacent tooth. The crown may not look great in relation to your other teeth. The unaesthetic look may also be caused by wrong colour selection. This can usually be corrected by remaking the crown.
Implants are becoming the new norm in the dental field and for good reason. They preserve bone structure, can last a long time, and mimic our natural dentition in many ways. My hope is that this post prepares you for the rare, but real risks. Preparation is key to success. Find a professional that is patient and trained.
Stay stay and keep smiling.