Tooth Implants What is the difference between success and Failure?
Tooth Implants are often presented to patients as a perfect or near replacement for missing teeth. They are rarely informed of the risks and counseled on the failure rates. These procedures can have severe negative consequences and are not always successful. Implants may and often fail. Patients should be aware about the risks and realize that Tooth Implants can fail. With the right planning implant placement can be secure, predictable and provides a an aesthetic and functional outcome for patients.
Tooth Implants are a vast cry from their 1950’s inception. Tooth Implant technology is changing at an incredibly fast rate. As each new technology is modified, Tooth Implant success usually improves. Sometimes, a new technology enters the marketplace that is mostly good for marketing, but does help the success, or actually hinders it. Fortunately, it doesn’t happen that often.
What triggers Tooth Implants to fail? There are many reasons that contribute to a higher risk of Tooth Implant failure. Unfortunately some of the risks are not avoidable and this is the reason Tooth Implants are between 90 and 95% successful based on various studies (the number is actually close to 95 percent). Like long bone fractures even with the most precise estimation of the fracture and great immobility, some fractures don’t heal when the casting is taken off. The fracture may be non-union (meaning no healing ever really began) or the fibrous union happens (where instead of bone between the two sides of the fracture you have scar tissue). Depending on the type and the location of the fracture as well as the patient, non-unions as well as fibrous unions are commonplace around five percent of the time. This is similar to the failure rate for Tooth Implants.
The same principles of healing from a broken bone are compatible with healing an implant. You need good approximation of the bone to the implant surface and a period of immobility to ensure a successful implant osseointegration. Osseointegration happens when bone accepts the implant and then fuses itself to it. The rate of failure for implants is similar to fractures that don’t heal correctly. It is possible that the bone fail to join, just like non-unions. Instead of having bone surrounding the implant, you get fibrous encapsulation. It is similar to the fibrous joint that occurs in bone fractures.
Implant failure is often caused by poorly managed diabetes and bone diseases, congenital or congenital and certain medicines like glucocorticoids (prednisone), immunosupressants, and bisphosphonate medicines (Zometa Fosamax Actonel Boniva, Fosamax and Actonel). Smoking and poor hygiene could increase the chance of implant failure. Patients suffering from these conditions or who are taking these medications should bring those to the attention by their surgeon so they can develop a treatment plan that is designed to suit their needs and their medical condition.
There are other factors that can lead to the increase of Tooth Implant failure. Implants may fail early during the healing process or later in the healing phase. Early failures would be defined as any point in time prior to when osseointegration occurs (healing phase) or at the time the crown is fixed to the implant. Late failure refers to any time the tooth has lost its function and the implant is no longer in good condition.
Factors that could cause early failure are:
The failure type is usually observed soon after the implants are placed. It are caused by:
- The bone is overheated when it is time to perform surgery (usually because of a lack of proper irrigation)
- Too much force when they are placed (too snug fitting implants could actually cause bone to resorb)
- There isn’t enough force to hold them in place (too loose fitting implants can remain stationary and heal correctly)
- Contaminated implant infection contaminated osteotomy epithelial cells in osteotomy site (connective tissue, also known as scar tissue fills the space around the implant, instead of bone)
Bones of poor quality
overly strong forces during osseointegration (during healing the implant is under function, is mobile, therefore bone cannot connect to the implants) inadequate follow-up with post-operative medications or other instructions. Tooth Implants uncommon reasons, such as implant rejection from a titanium alloy allergy.
A lack of hygiene is a frequent cause of late-onset failures. Unhygienic habits can result in dental patients losing teeth. Some people continue this habit even after having implant surgery. Sometimes, the implant is overloaded. Certain patients are more prone to forces of bite and might require more implants to distribute the forces more harmoniously. Lateral forces can cause implants to fail later. Implants, like teeth, like to be placed straight down and up, which is known as axially. When teeth and especially implants are loaded laterally or tangentially they weaken the bone around them and start to fail. Another cause is poorly planned placement of the implant, improper implant placement and/or a poorly created prosthetic tooth or device. Implants can also fail for various reasons. Some of them are avoidable while others aren’t. How can patients protect their chances of avoiding and reducing the chance of a failed implant? The biggest help patients can provide is to be on top of the medications and instructions before and after the procedure. The second is taking the opportunity to quit smoking.
The most important factor to guarantee the greatest chance of success is finding the ideal surgeon and dentist. Look for an experienced implant surgeon. This field includes Periodontists and Oral Surgeons. Implants are usually carried out in a group. It is important to ensure that the surgeon who will implant you is certified. The qualifications of the dentist who will repair the implant (putting the tooth in it) are also important. Be sure to ask many questions. Request to see before and after images and request testimonials from other patients.
Implantology (placing of implants) can be a difficult and technically demanding procedure. Experience and a good plan are essential to achieve success. Although training is important, having knowledge in the field of your interest can make it even more valuable. Ask your surgeon whether they’re board-certified and for how long they’ve been implanting dental implants. Also, inquire if they communicate with restorative dentists.