Dental implant failure is a complex issue with many underlying causes, causing great pain, difficulty, and additional expenses.
It may result from the dentist, dental laboratory, or manufacturer’s error, even though the patient should mostly maintain good oral hygiene and follow post-operative care guidelines. That said, implants have a “success rate of 97% at 10 years and 75% at 20 years,” so failures are relatively rare.
This comprehensive guide will explore the complexities of dental implant failure and its possible causes and reasons. By understanding these factors, you can make informed decisions and take appropriate action in the event of implant failure.
Introduction to Dental Implant Failure
Dental implants are screw-like structures surgically inserted into the jawbone. They provide a stable foundation for dentures, crowns, and bridges and are a natural-looking and functional solution for tooth loss.
Importance of dental implants
Dental implants have multiple benefits over conventional tooth replacement methods and are considered a significant improvement in restorative dentistry. These benefits include:
- Stability: Implants provide a stable foundation for crowns and bridges, providing a secure and comfortable fit.
- Durability: With proper care, dental implants can last up to many years.
- Aesthetics: Dental implants can restore your teeth’s natural appearance and function.
- Bone preservation: Implants preserve bone, preventing bone loss, which is an inevitable consequence of missing teeth.
- Improved speech and chewing: Implants can enhance your ability to speak and eat comfortably.
Dental implant failure
Dental implant failure is classified as early or late. Early implant failure means an implant showing clinical mobility before the placement of the final crown. It is usually caused by biological problems, where the body “rejects” the dental implant. Early implant failure may be linked to immunological, genetic, and immunological factors.
Common Causes of Dental Implant Failure
Implant failure can be multifactorial. Age and sex, smoking, systemic diseases, implant site, quantity and quality of bone, and implant surface treatments and features are some of the statistically analyzed factors linked to implant failure.
Local causes of Dental Implant Failure
- Insufficient Bone Quantity and Quality: If the jawbone is not dense enough, it might not be able to support the implant sufficiently.
- Bone resorption: The jawbone may gradually weaken with age, particularly in regions where teeth are missing. As a result, implant placement may become difficult.
- Poor Oral Hygiene: Poor oral hygiene leads to Tartar and plaque buildup around the implant, irritating the soft tissues and eventually involving the bone, which may result in implant failure and bone loss. It can be a contributing factor in peri-implantitis and other oral health issues.
- Peri-implantitis: Peri-implantitis is inflammation of the soft and hard gum tissues around dental implants. Similar to a natural tooth, bacteria can build up on the base of the implant, below the gum line. Over time, the bacteria irritate the gum tissue, causing it to become inflamed, damaging the tissue and, if not caught early, deteriorating the bone structure below the implant.
- Failed osseointegration: Lack of bone-to-implant contact: For successful integration, the implant must properly integrate with the surrounding bone. If this bond is not established, the implant may fail.
- Incorrect placement: Angle or depth: If the implant is placed at an incorrect angle or depth, This will cause improper force distribution. Inadequate support and stability will eventually lead to implant failure.
Systemic causes of Dental Implant Failure
Older individuals have worse local bone problems and longer possible healing durations and are more susceptible to changing systemic health conditions. The chance of an implant failing rises with increasing age.
There are several systemic causes of Dental implant failure, including smoking, bruxism, diabetes, cardiovascular disorders, osteoporosis, corticosteroids, and bisphosphonates.
Smoking: Smoking reduces blood flow, which impairs the osseointegration process. Due to uncontrolled functional loading, patients with bruxism are more likely than those without parafunction to develop implant failure.
Diabetes: Diabetes can have systemic effects like poor wound healing, increased susceptibility to infection, and microvascular and macrovascular illnesses. Still, it is not a direct risk factor for dental implant issues or failure.
Cardiovascular disease: Cardiovascular disease can affect the success of implants by directly reducing oxygen delivery, delaying healing, and reducing blood flow to tissues, which may affect how the body responds to osseointegration.
Osteoporosis: Osteoporosis causes bones to become weak and brittle, with reduced mineral density in typically mineralized bone. Implant osseointegration may be impacted by osteoporosis-related decreased bone metabolism.
Medications: Medications like corticosteroids can also contribute to implant failure. Their frequent use suppresses a patient’s immune system, increasing their risk of contracting infections. Patients on systemic corticosteroid therapy are more likely to experience decreased bone density, increased epithelial fragility, and immunological suppression, which affects the dental implant’s ability to osseointegrate.
Bisphosphonates, a class of medications that inhibit bone resorption by inhibiting osteoclast activity, are associated with cases of avascular necrosis (osteonecrosis) of the mandible and maxilla.
What are some common symptoms indicating Dental implant failure?
The initial step in treatment is to detect and diagnose the malfunctioning implant. Possible clinical indications and symptoms of implant failure include mobility, edema, discomfort, pus, bleeding, and radiographic evidence of peri-implant bone loss.
Responsibility of the Patient in Dental Implant Failure
While various factors can influence dental implant failure, the patient’s role in maintaining oral health and following post-operative care instructions is crucial.
Importance of following postoperative Care Instructions
Healing process: Following the post-operative care instructions prescribed by the dentist impacts the healing process and lowers the risk of complications.
Infection prevention: Complying with instructions regarding oral hygiene, diet, and medications can help prevent infections and encourage healthy tissue healing.
Preserving Good Oral Hygiene Flossing and Brushing: Regular flossing and brushing are important for avoiding gum disease and plaque accumulation, both of which can contribute to implant failure.
Mouthwash: Using a mouthwash recommended by your dentist can help kill bacteria and reduce the risk of infection.
Regular check-ups: Attending regular dental check-ups is vital for monitoring the health of your implants and addressing any potential issues early on.
Responsibility of the Dentist in Dental Implant Failure
Proper patient assessment and treatment planning
The dentist plays a crucial role in maintaining the success of dental implants. They must conduct a thorough assessment of the patient’s oral health, including bone density, gum health, and overall medical history, and develop a customized treatment plan based on the patient’s individual needs.
Surgical skill and technique
The dentist should have the necessary surgical skills and expertise to perform the implant procedure successfully and minimize complications like nerve damage or implant misplacement.
Quality of materials used
The quality of materials used should be high-quality from reputable manufacturers and biocompatible with the patient’s body.
Postoperative care and follow-up
The dentist should provide clear instructions for post-operative care, including medications, diet, and oral hygiene. Regular check-ups are essential for monitoring the healing process and addressing potential issues. By fulfilling these responsibilities, the dentist can significantly contribute to the success of dental implant treatment and reduce the risk of failure.
Legal and Ethical Considerations in Dental Implant Failure
Informed consent and patient education: Dental implant failure is a serious issue that requires clear communication and informed consent from patients.
Professional liability and malpractice: Dentists must adhere to accepted standards of care and document the procedure for protection in cases of legal disputes.
Patient rights and responsibilities: Patients have the right to information and responsibility for care and may have grounds for malpractice claims if they believe the dentist’s negligence contributed to the failure.
Legal recourse in case of implant failure: Legal professionals can provide expert testimony and help navigate the statute of limitations in your jurisdiction. Consultation with a legal professional is crucial for guidance on your rights and options.
Conclusion
Dental implant failure is a complex issue that can arise from various factors, including patient-related factors, dental professional errors, and material defects. While patients play a crucial role in maintaining oral health and following post-operative care instructions, the responsibility for implant failure can also extend to the dentist and dental laboratory.
Understanding the potential causes of implant failure and the roles of the different parties involved is essential for individuals who have experienced such an unfortunate event. By being informed, patients can make informed decisions and take appropriate actions if necessary.
If you have experienced dental implant failure, consulting with a legal professional can help you understand your rights and explore potential avenues for recourse.
