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Dental implants
Risks and complications

author icon By Dr. George Ghidrai

Risks and complications can be divided into risks during surgery, risks and complications that occur in the first 6 months after the placement and long term risks and complications.

1. Risks and complications during implant surgery

Placement of dental implants is a surgical procedure and carries the normal risks of surgery. If additional surgical procedures are performed (sinus lift, bone graft etc.), they also carry the normal risks.

However, the risk of complications is considered to be very low - less than 5 percent, according to current statistics. Problems are rare and when they do occur, they are usually minor and easily treated.

  • Bleeding

    Life-threatening events associated with dental implants are extremely rare but some severe bleeding may occur especially if large blood vessels are injured during surgery.

    If such an accident should occur, treatment includes compression, vasoconstrictive medication, cautery or ligation of arteries. Most of the times, bleeding is kept under control.

  • Infection

    Infection from bacteria is a common risk to any surgery. In modern days, less than 1% of the surgeries result in an infection and most of those infections are minor.

    An infection at the implant site during surgery or in the early days after surgery can increase the risk of implant failure. Pre-op antibiotics reduce the risk of implant failure but have little impact on the risk of infection.

    Proper oral hygiene after surgery is essential. A clean mouth will heal faster and the risk of infection is reduced if the mouth is not riddled with bacteria and food debris.

  • Nerve damage

    The most common issue is when the inferior alveolar nerve (located inside the mandible) is accidentally damaged during surgery. After surgery, patients may experience lingering pain, tingling and numbness in the teeth, gums, lips (mostly the lower lip) or chin for an undetermined time.

    If the nerve damage is minor, patients will recover after a certain period of time.

    dental implants risk : important anatomic structures that can be damaged during implant surgery

    important anatomic structures
    that can be damaged during implant surgery

  • Sinus problems

    Sinus problems occur when dental implants placed in the upper jaw protrude into one of the sinus cavities. Careful planning and precise surgery execution are essential to avoid this accident.

    dental implants risks : sinus penetration dental implants risks : sinus penetration dental implants risks : sinus penetration

    panoramic film : a dental implant protrudes into the sinus cavity

    Even if sinus complications do not occur in every case, these implants have a high risk of failure because of the insufficient bone support.

  • Lack of stability

    An 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.

    Some research even suggests that the primary stability of the implant in bone is a more important determinant of success of implant integration, rather than a certain period of healing time.

  • Other risks

    Other accidents may occur during the surgical placement, but these are extremely rare : damage (and possible devitalization) of adjacent teeth or other surrounding structures, necrosis of the flap of tissue around the implant, mandibular fracture etc.

2. Risks and complications in the first 6 months

These complications occur in the first 6 months after implant placement. The most common complication is the failure to integrate.

3. Long term complications

Long-term implant failures may be caused by an improper design of the prosthetic restoration or by inappropriate care and maintenance. Regardless of the cause, implants fail due to either loss of bone around them or a mechanical failure of the implant.

There are also the risks associated with the prosthetic components which over time can wear off, chip, break or cause a lack of satisfaction on the part of the patient.

Patients who wear implant supported prosthesis should ideally be free of pain or any other unpleasant signs, able to chew and taste and be pleased with the aesthetics.

Implants should be tested at least twice a year during regular checkups. Criteria for the success are the absence of pain, mobility, radiographic lucency (greater than 1.5 mm) around implants, the lack of suppuration or bleeding in the soft tissues, adequate function, and aesthetics in the prosthetic.

Last review and update: February 2019

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