Dental implants are a very predictable and successful procedure. However, a small percentage experience problems. Most are associated with the implant to bone interface and can occur at different stages over the life of the implant. Fortunately, in most cases, either a replacement implant can be placed or remediation of the existing implant can resolve a developing problem.
Our experience has been very positive when faced with this challenge. All of our cases where we experienced an initial problem have been successful when a second implant needed to be placed. The additional time to achieve a successful finish to these cases becomes a reality but in retrospect, our patients appreciate our determination to achieve their treatment goals.
This usually involves a failure to achieve osseointegration; the migration of bone that forms an attachment to the surface of the implant that results in structural rigidity. Some of the factors involved are:
These are usually seen soon after the implant has been exposed or placed into function. Although seemingly normal on xray examination and routine evaluation for stability, the quality of the implant to bone attachment is inadequate. Once recognized, the implant may be allowed to heal for an additional time or removed entirely if circumstances suggest
Most of the issues seen over the course of time are related to either excessive or misdirected forces on the implant restoration. These forces are transmitted through the restoration to the supporting implant fixture and can initiate deterioration of the attachment to the bone and/or damage to the restoration.
Many of our patients have clenching/grinding habits, which may have been the underlying cause of the tooth needing to be extracted and the necessity of the implant being placed. Implants have less of a protective mechanism than teeth and the need to control those underlying forces remains. How your teeth function changes over time due to shifting and this means that periodic routine assessment of how the implant restoration is functioning in this ever changing environment is crucial to long term success. As necessary, adjustments to the biting surfaces of the teeth may be necessary to have the teeth continue to function smoothly.