There are many ways to restore teeth, but dental implants are the only replacement known to replace roots of teeth. Proper placement and osseointegration (bone integration) can provide hard and soft tissue stimulation, preserving bone mass and keeping tissue healthy. However, due to multiple reasons, implants sometimes fail. An accurate diagnosis should be obtained as soon as an implant begins to fail..
Types of Implant Failure
There are three categories used to describe implant failure in root form implants. The first and most mild ailing. An ailing implant is an implant starting to show signs of inflammation (redness around implant or abutment) and mild bone loss. The next is failing. This is when the implant is showing increased signs of bone loss. This should be corrected immediately, and the source of the problem should be uncovered. It could be poor hygiene, malocclusion (bad bite adjustments), infection, or that osseointegration did not fully complete. Bone should be grafted in the areas where it is resorbed, and immediate implant rehabilitation should be started to save the implant. The final and most severe classification of implant failure is failed. There is no solution for an already failed implant with mobility. It must be removed, new bone grafts placed to preserve the site, and a new implant placed four months later.
This type of failure happens shortly after the implants are placed. When there is not enough water used during an implant procedure, the bone can overheat (necrosis). This is known as a technique error. Another technique error is using too much or not enough force, also known as torque, at the time of the procedure. Poor bone quality, insufficient or ineffective bone grafting, contamination during the procedure, and excessive force from chewing or biting pressure during the osseointegration process can all cause early implant failures. Improperly placed temporaries may result in excessive force upon the implant preventing osseointegration from happening at all.
Implants that become loose or fall out after a significant period of time usually succumb to excessive forces. This could be because of a shift in the way one bites down, or changes in resting position for upper and lower jaws, as well as posture when you sleep. Frequent clenching down and wear and tear on other teeth may also have something to do with the mobility of the implant. Function of the occlusal relationship is crucial for success of an implant.
What Causes Implant Failure?
An implant with a prosthesis (crown, or bridge on top of it) may be failing due to the restoration itself. Abutments may require new screws, or the abutment and restoration may need to be remade in order to keep the integrity of the implant. An error in treatment planning can cause the use of incorrect implant sizes, types, quantity, positions and lengths. All of these can cause overloading and may result in failure or fracture. A fractured implant must be removed as soon as possible to avoid further trauma and damage to bone structures underneath.
What Causes Prosthetic Failure?
A prosthetic failure is due to the prosthesis being retained on the implant improperly. Large bridge work or extensive crowning should be screwed into the abutments, not cemented. Some failures are due to the materials used to fabricate the crown or bridgework and the opposing teeth. The teeth surrounding the implant are just as important to the health of that implant, as the implant itself. Dr. Koeppel, director of Koeppel Dental Group looks at all of these factors before treatment planning a patient.
The Implant Restoration Process
When an implant has failed, it must be removed. Discolorations, seepage of bacteria and damage to surrounding teeth, and bone can happen without early diagnosis and treatment of a failed implant. Once it is diagnosed, the site is re-prepared with more bone graft material and allowed to heal. A new implant is then placed in the site and also allowed to heal. This new implant might be a different type, size, width, and height to accommodate the site better. Repairs and replacements of these implant failures are completed by our board-certified oral surgeon as soon as possible to restore the occlusal relationship between the upper and lower jaws, as well as a space maintainer to preserve the space. It is crucial to maintain good oral health when you have implants and bridgework. It requires routine hygiene visits and at home habits to avoid accumulation of bacteria and infection.