The gold standard for replacing missing teeth today is dental implants. The prevalence of implants in dentistry has been attributed to their high success rate, thanks to technological advancements and implant systems. Despite the innovations, certain factors, like age, systemic disease, smoking, bone quality, the location of the implant, and many others, can increase the risk of implant complications and failure. If you are considering implants, you must know about the complications and failures associated with the treatment modality.

Dental Implant Complication vs. Failure

Before delving into the risk factors, you should understand the distinction between a complication and failure. A complication is an issue with the dental implants that can be fixed without needing replacement, like a loose titanium post or a chipped crown. In contrast, an implant failure refers to a terminal problem with the artificial tooth root that is structurally unsound and requires replacement, not repairs. The primary cause of dental implant failure in the early stages is failed healing or osseointegration when the metal posts fail to fuse with the natural bone. Late failure stems from severe oral infections or facial trauma.

Early Dental Implant Complications

When your oral surgeon surgically places the artificial tooth root on the open socket, it takes approximately half a year for the bone to fuse or integrate with the surrounding jawbone. The process is called osseointegration. Early complications develop during this healing period and are linked to surgical treatment. They include:

Osseointegration Difficulties

Failed osseointegration or healing is one early complication that can indicate implant failure. Healing failure occurs due to low jawbone density or quality, denying the artificial tooth root the anchorage it requires to function optimally. Additionally, a jawbone that has suffered osteoporosis is prone to fractures, leading to complications. Also, smoking slows down healing as it limits the flow of blood to the gingival tissue.

An inexperienced oral surgeon can also contribute to the osseointegration difficulties when they fail to place the implant accordingly. When healing fails to happen as required, you begin to experience problems on the implant site in the first few months. Quitting smoking and treating an infection can fix the issues and prevent implant failure. However, if the implant was improperly placed, you might be forced to remove the artificial roots and wait for healing before replacing them.

Peri-Implantitis and Inflammation

Peri-implantitis is the bacterial infection of the implantation site, and it can compromise the healing process. The disease can occur due to contamination of the surgical tools or failure by the dental expert to address an active oral infection before the surgery. Refusal to comply with the dentist’s post-surgery instructions, such as observing proper oral hygiene, can also lead to the contamination of the surgical site by harmful bacteria, leading to infection.

Symptoms that point to peri-implantitis include:

  • Constant pain around the implant
  • Swelling in the surgical area that does not go away
  • Readiness of the gums surrounding the site

When you observe these symptoms in the first few weeks or months of the procedure, it could be indicative of early complications. Seeking treatment at the onset of these complications can prevent a replacement. Your dental expert will administer antibiotics and clean the site to eliminate the harmful bacteria. Once the infection is eradicated, osseointegration continues.

Surgical Problems

During the surgery, the surrounding soft tissues and nerves could be injured, depending on the skills and experience of your dental surgeon. Excessive inflammation, separation of wound edges, and hematoma are the common soft tissue problems that can develop shortly after the treatment. The numbing during surgery also exposes you to the risk of nerve damage that manifests as tingling or numbness.

Late Implant Complications

Late complications happen months or years after successful osseointegration and attachment of the prosthesis to the implant. Chronic diseases, natural physiological body changes, and mechanical issues are the leading causes of these complications in the long run.

  1. Late-Onset Infection

Infection of the implant site or peri-implantitis, as an inflammation or disease that affects the soft tissues surrounding the artificial tooth root, which, when left to advance, causes persistent jawbone deterioration and eventually dental implant failure. You can develop the inflammation even after proper healing of the implantation site. Peri-implantitis, like other oral infections, stems from poor dental hygiene that allows the growth and accumulation of harmful bacteria in the mouth. In the early stages, the bacteria cause gingivitis, which is characterized by redness and inflammation of the gums. Gingivitis then progresses into gum disease or periodontitis, which is irreversible. When periodontal disease develops around an implant site, it results in peri-implantitis. The condition causes treatment failure, damaging the ligaments, soft tissue, and the bone surrounding the implant.

  1. Prosthetic Failure

The purpose of the dental implant is to stimulate the jawbone to prevent bone loss and to support the prosthetic, which is the artificial tooth visible through the mouth. There are several prosthetic options to select from, including dental bridges and crowns. The prosthetics are not as durable as the implant, so they start to wear out after some time. This causes them to loosen or break. If the prosthetic fails, the entire treatment is deemed a failure.

The titanium posts can also be affected by your oral habits, such as occlusal overload, which compromises the structural integrity of the artificial roots. If your implants become loose, they do not provide the stability the prosthetic needs, making the procedure fail. Sometimes the posts or screws can even fracture, necessitating a replacement.

Implant Failure Risk Factors

Several factors contribute to the success or failure of the implants. These Include:

Age Factor

Senior citizens or those above sixty years are susceptible to systemic conditions like uncontrolled diabetes, autoimmune disorders, and osteoporosis, minimizing the chances of implant survival. A condition like uncontrolled diabetes lowers the body’s immune system and reduces the body’s healing capacity. Therefore, your implant wound takes longer to heal, and the risk of bacterial infection is elevated. Osteoporosis reduces jawbone quality and stability for the implant. Adults continue to receive implants, but the risk of treatment failure increases with age, with senior citizens being the most susceptible. Therefore, before undergoing an implantation procedure, you must consider your age and whether you suffer from any systemic conditions that could cause the treatment to fail.

Dental Hygiene and Maintenance

Like natural teeth, dental implants require diligent dental hygiene to stay healthy. Therefore, your capacity to observe diligent oral hygiene will affect the success of the implants. If you keep up with poor dental hygiene practices like failure to brush and floss teeth as required, the teeth will accumulate plaque and calculus, breeding grounds for harmful bacteria. The bacterial infection causes gingivitis, periodontitis, and eventually peri-implantitis when the infection attacks the implant site. Besides, the risk of infection on the implantation site is high when you have a history of periodontal disease.

You can minimize the risk of the treatment failing by using interproximal brushes that can penetrate up to 3 mm into the gingival pockets to remove plaque or calculus accumulation. Additionally, you should visit your dentist regularly for evaluation. Your dental expert will check if you have any plaque and calculus buildup and remove it before it causes any damage. The checkup also enables the dentist to examine your prosthetic, the connector’s stability, the soft tissue lines surrounding the implant area, and the implant structure. If there are any abnormalities, they can be addressed before causing implant failure.

Bruxism or Parafunction

Parafunction refers to conditions like jaw clenching or teeth grinding. When you suffer from bruxism, the chances of implants failing because of immediate occlusal overload are high. Occlusal overload is the application of excessive force on the teeth, which causes micro-motions that stress the jawbone and weaken the implant. Because of parafunction, micro-movements become common when the implants become unstable immediately after treatment.

Usually, the artificial root is not properly anchored to the jawbone until osseointegration occurs. Some dentists place the prosthetic tooth immediately after the implantation. For patients suffering from teeth grinding issues, the implant will experience an occlusal overload immediately, which causes micro-motions.

If you begin these habits immediately after the procedure, the fibers encapsulate the titanium screws instead of integrating with the jawbone. However, for damage that prevents osseointegration from happening, there must be several micro-motions around the interface of the bone and the metal screws. An isolated risk incident that generates micro-movements will not cause the implants of a bruxer to fail.

Habitual Cigarette Smoking

Smoking negatively impacts the health of your mouth and your general health. Smoking reduces the body’s ability to resist infection, increasing the risk of peri-implantitis. Also, it decreases the body’s capacity to absorb calcium, lowering the survival rate of your artificial tooth roots. Furthermore, smoking is associated with limited blood flow to the gums because of peripheral resistance. Insufficient blood flow to the gums slows the osseointegration process and increases the risk of developing peri-implantitis. The carbon dioxide and nicotine in cigarettes slow down the recovery process, with smokers taking longer to heal than non-smokers.

Peri-Implantitis

Bacterial infection that causes the soft tissues and the bone surrounding the implantation area to swell, leading to jawbone loss and eventually treatment failure, is peri-implantitis. The symptoms of the condition  include:

  • Bleeding in the gums
  • Increased pocket depth
  • Implant mobility
  • Radiographic evidence of jawbone loss

If you notice these symptoms, you should consult your dentist for treatment. Using systemic antibiotics for around twelve months can lower the anaerobic bacterial count and help stop the infection from going deeper.

Improper Implantation

An implant must be placed on the proper axis to be structurally sound. Also, when the roots from the surrounding natural teeth are dilacerated and tilting towards the space left by the missing teeth, implanting the artificial implant can be problematic, especially for a dental surgeon with no experience handling these cases. 

Dental surgeons are not equal, and your implants will likely be improperly placed, leading to failure if you hire an inexperienced expert. So, look for an experienced oral surgeon for proper implant placement.

Signs of Dental Implant Failure

Whether you are in the first weeks of recovery or have successfully healed, the following signs could indicate that your implant has an issue:

  • Chewing problems
  • Swelling of the gingival tissue
  • Receding gums
  • Implant or prosthetic mobility
  • Persistent pain

When you observe these signs, your body could signal that the implants have failed. You should visit your dentist as soon as possible to determine if the implant can be saved or if replacement will be required. Early intervention can prevent implant failure and replacement.

Preventing Implant Failure

It is challenging to prevent implant treatment failure. However, you can minimize the risk of treatment failure through:

  • Observing diligent oral hygiene
  • Visiting the dentist for routine checkups at least twice a year
  • Stopping cigarette smoking
  • Increasing your calcium intake for a stronger jawbone by taking foods that are rich in calcium, like cheese, milk, broccoli, and oranges
  • Wearing a mouth guard if you suffer from parafunction
  • Avoid poor oral habits that damage your teeth or increase the risk of bacterial infection, like eating sugary substances.

Alternatives for Dental Implants

Understanding the risk factors that could lead to implant complications and failure is proper. If you are more prone to treatment failure, you can discuss other suitable alternatives for replacing the missing teeth.

If you are not a candidate for implants because your jawbone is immature, you can opt for dental bridges. Several bridge options exist, like conventional bridges, resin-bonded bridges, and cantilever bridges. Discuss these options and select the most suitable choice.

Also, you can use partial dentures, which replace missing teeth without interfering with the jawbone.

Being ineligible for dental implants should not discourage you from exploring these alternatives. However, you must examine them and their pros and cons to make the right choice.

Find a Reputable Advanced Dentistry Service Near Me

Dental implants have been tested and proven effective in replacing the natural tooth roots. However, like other surgical procedures, implants have complications and failures. There is a need to increase awareness of these problems among patients before they undergo the treatment. At Northridge Advanced Dentistry, our oral surgeons are knowledgeable in implant dentistry and adopt innovative treatment procedures to minimize the risks. Additionally, we will explain the potential complications and risk factors that could lead to treatment failure. If you are ineligible, we will explore other tooth replacement options. Call us at 818-701-3010 for a no-obligation consultation.