Understanding Dental Implants: Why Some Fail

For many, dental implants represent a modern marvel. They offer a solution to a myriad of dental problems from missing teeth to ineffective dentures.

The success rates of implants are impressively high, averaging around 90%-95% according to studies. But what about that 5%?

The small percentage of cases where implants fail can be concerning, not just for dental professionals but also for patients considering this procedure.

In this post, we look into the reasons behind implant failure, shedding light on the various factors that can lead to this outcome.

By understanding the potential reasons for failure, patients, like you, and professionals can work together to minimize these risks, ensuring a higher likelihood of successful outcomes.

The Basics: What Is a Dental Implant?

Before we explore the reasons for failure, it’s essential to understand the fundamentals of dental implants.

When a dental implant is put in, it connects to the bone in the jaw or head. Then, it serves as an anchor for a dental prosthesis like a crown, bridge, or denture. The process of fusing with the bone is called osseointegration, and it’s this biological mechanism that gives dental implants their strength and stability.

Made of biocompatible materials like titanium, these artificial tooth roots can last a lifetime if properly cared for and if the patient follows post-procedural instructions diligently.

Why Do Some Dental Implants Fail?

1. Patient-Related FactorsOne of the critical factors in the success of dental implants is the patient. Patients with certain health conditions, particularly those that affect the immune system or the body’s ability to heal, are at a higher risk for implant failure.These may include uncontrolled diabetes, cancer, or autoimmune diseases. Additionally, lifestyle habits such as smoking and inadequate oral hygiene can negatively impact the osseointegration process.
2. The Impact of SmokingTobacco use is one of the most significant risk factors for dental implant failure. The chemicals in tobacco products restrict blood flow, which is crucial for the healing process.Smoking also inhibits the body’s natural immune response, making it more susceptible to infection. For dental implant patients who smoke, it’s advisable to quit before the surgery or, at the very least, to quit smoking during the critical healing period.
3. The Role of Oral HygieneGood oral hygiene is essential for all patients but is particularly critical for those with dental implants.Bacteria that cause periodontal disease, a severe form of gum disease, can accumulate around implants, leading to bone loss and potentially implant failure. Patients with implants need to be vigilant about their oral care routine, which should include regular brushing, flossing, and professional cleanings.
4. Surgical Technique and Implant PlacementImplant failure can also be attributed to the dental professional’s surgical technique and the way the implant is placed. An incorrectly placed implant may not be able to withstand the forces of chewing, leading to mechanical failure.Inadequate sterilization techniques can introduce pathogens into the surgical site, causing infection. Dental professionals must be highly skilled and experienced in implant placement, and for patients to choose their provider carefully.
5. Inadequate Bone Quantity and QualityAn implant’s success largely depends on the quality and quantity of the jawbone available to support the implant.If the jawbone is not sufficient or lacks the density required for osseointegration, the implant may not be able to bond with the bone. In such cases, bone grafting may be necessary before implant placement to ensure a stable foundation.
6. Nerve and Tissue DamageDuring implant surgery, there’s a risk of nerve damage, particularly in the lower jaw where the nerves are closer to the surface.Nerve damage can result in numbness or tingling in the lips, chin, or tongue, which may be temporary or permanent. Tissue damage can also occur, affecting the implant’s ability to integrate with bone properly.
7. Infection and InflammationInfections that occur after implant placement can threaten the success of the procedure.Symptoms of infection may include pain, swelling, and suppuration (discharge of pus). Inflammation, which is a natural response to surgery, can be excessive in some cases, leading to a delayed healing process and, potentially, implant failure.To mitigate these risks, dental professionals may prescribe prophylactic antibiotics and anti-inflammatory medications.
8. Peri-ImplantitisA particular concern for those with dental implants is peri-implantitis, a condition similar to periodontal disease that affects the tissues around implants.It’s characterized by inflammation and the progressive loss of bone around the implant, which can ultimately lead to implant failure. Good oral hygiene and regular professional cleanings can help prevent peri-implantitis.
9. Mechanical and Loading FactorsOnce an implant has successfully integrated, additional mechanical and loading factors can still cause failure.These include excessive bite forces, bruxism (teeth grinding), and parafunction (non-functional jaw movements). Overloading implants with forces they can’t bear can lead to the breakdown of the bone-implant interface.
10. Improperly Designed ProstheticsThe prosthesis attached to the implant must be designed to distribute bite forces evenly. Poorly designed prosthetics can put too much stress on the implant, leading to failure.Dental professionals need to use precise measurements when creating the prosthesis and for patients to alert their provider of any discomfort that may indicate an issue with the fit of their implant-supported teeth.
11. Timing of LoadingThe timing of when the prosthesis is loaded onto the implant is also crucial.Loading too early, before osseointegration is fully established, can disrupt the healing process and lead to failure.Conversely, waiting too long to load the implant can result in inadequate stress during the healing period, which is also not ideal.
12. Allergic Reactions and Foreign Body RejectionPatients may sometimes have an allergic response to the materials used in the implant. This can cause inflammation and discomfort, leading to implant failure.Additionally, the body’s immune system may recognize the implant as a foreign object and reject it. These instances are rare, but patients need to communicate any signs of discomfort with their dental professional.

Prevention and Treatment of Implant Failure

Understanding the factors that can lead to implant failure is the first step in preventing it.

Patients can minimize risk by maintaining good oral hygiene, quitting smoking, and managing their overall health. Choosing a skilled and experienced dental professional is also crucial, as is following their post-operative instructions diligently.

When implant failure occurs, it’s essential to seek treatment as soon as possible. The approach to treatment will vary depending on the cause of the failure.

In some cases, the implant can be salvaged with proper intervention, while in others, it may need to be removed, and the site allowed to heal before a new implant can be placed.

Learn More About Dental Implants in Toronto, Ontario

While the prospect of dental implant failure can be daunting, keep in mind that the vast majority of implants are successful.

Patients who are informed about the potential risks and take an active role in their oral care have an excellent chance of enjoying the benefits that implants offer.

By working closely with a qualified dental professional and being vigilant about post-procedural care, you can increase the longevity of your dental implants and maintain a healthy, functional smile for years to come.