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Dental implant failure
Possible reasons

author icon By Dr. George Ghidrai

When dealing with toothloss, dental implants are considered today as the best treatment option. The great advantage of a dental implant is that it replaces the missing tooth in the most natural way possible. This happens because implants "fuse" with the bone thanks to a biological process called osseointegration.

Implant supported restorations give great aesthetic results and can last longer than most other treatment options like dental bridges or removable dentures.

dental implant supported bridge

However, when dealing with human body, there is no treatment option that gives one hundred percent positive result. That is why dental implant failure is a fact that should be accepted.

It is considered that the average success rate of dental implants is around 95%. This means if a dentist places 500 implants, an average of 25 of those will fail.

Even if there are many reasons for implant failure, the most common cause of failure is when the patient and the dentist try to settle for cheaper solution. Dental implant treatments are not cheap and there is a good reason for that.

Next we will try to summarize the most common reasons for dental implant failure:

  • Inadequate planning

    Planning for dental implants is probably the most important step of the entire treatment. Beside a thorough examination, dental implants need specific imaging methods such as panoramic X-rays or computed tomography, especially in more complex cases.

    Modern computer software is also available; this can be viable in the diagnosing of dental implant position and placement. Some dentists may try to shortcut these tests or go for cheaper solutions; this can increase the rate of implant failure.

  • Inadequate information about the patient general health or medical history

    Some serious general conditions make anesthesia, surgical procedures and the overall placement inadvisable while other situations should be evaluated on a case-by-case basis and may require some preliminary treatments.

    A thorough interview and diagnosis should be done to avoid any complications later on.

  • Improper planning and/or executing for the adjunctive surgical procedures

    For an implant to osseointegrate, it needs to be surrounded by a healthy quantity of bone. Therefore, the bone will have to achieve an adequate width and height. Implants placed in inadequate bone have a higher risk of failure.

    The adjunctive surgical procedures are planned to increase the amount of bone. Some procedures also aim to reposition anatomical structures that might interfere with the implants (sinus, alveolar nerve etc.). The most common adjunctive procedures are sinus lift and bone graft.

    These procedures are planned when the size and/or structure of the bone is not adequate to support the designed implants and will add to the total cost of the treatment. Despite that, these are vital for the long time success of the implants.

  • Inadequate dental implant fixtures

    Even though there are hundreds of companies that manufacture dental implant fixtures, only a few have really been keen in their research programs. Dental implants need to undergo extreme research, and research programs are usually quite expensive.

    This is one of the reasons implant procedures are expensive; because the dentist uses high quality fixtures.

  • Implant surgery risks

    Placement of dental implants is a surgical procedure and carries the normal risks of surgery. Some of these risks may lead to an increase in the rate of failure.

    For example, the inability to place the implant in bone to provide stability of the implant (referred to as primary stability of the implant) increases the risk of failure to osseointegration. The use of modern imaging methods (such as CT scan or CBCT) can significantly reduce these risks.

  • Restoring an improper occlusion or bite

    The long-term success of implants is determined, in part, by the forces they have to support. Therefore, restoring a proper occlusion (or bite) is one of the most important goals.

    It is essential not to overload the implants with additional pressures and to evenly distribute the chewing forces of the implants. Otherwise, there is a high risk of failure.

  • Inadequate care

    Dental implants require regular professional maintenance as well as proper home care. Taking good care of dental implants is vital for long-term success.

What can we do to avoid problems with dental implants ?

Try to find an experienced doctor who you'll trust; you can talk to former patients to ask for their feedback or maybe a friend or relative can recommend a dental surgeon.

Do not opt for cheap solutions; if your dentist recommends modern imaging methods or adjunctive surgery, take his advice; remember, it will cost you much more if the implants fail in a short time.

Follow all the care measures and don't forget that regular checkups should be conducted at least twice a year.

Last review and update: February 2019

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