What Makes a Success of Tooth Implants?
Tooth Implants are often presented to patients as a perfect or near replacement for missing teeth, but they must be informed of the risks and failure rates. Unfortunately, these procedures have serious negative outcomes and not always successful; implants may fail. Patients should be aware that Tooth Implants have potential failure rates so they can plan accordingly and ensure secure, predictable placement with an aesthetic and functional outcome in mind.
Tooth Implants have evolved greatly since their 1950s inception, with technology evolving at an astonishingly fast rate. As each new innovation is modified and adopted by the market place, success rates often improve. On occasion, a new innovation may enter the marketplace that may aid marketing but ultimately hinder success – fortunately this does not happen very often.
What causes Tooth Implant failure? There are various factors that may contribute to a higher risk of Tooth Implant failure. Unfortunately, certain risks cannot be avoided and this explains why studies have indicated that Tooth Implants have an overall success rate between 90-95% (with some estimates reaching close to 95%). Even with precise measurement and extensive immobility, some long bone fractures fail to heal when casting is removed. Fractures may be non-unions (meaning no healing has ever taken place), or fibrous unions (where instead of bone between two sides there is scar tissue). Depending on the type and location of the fracture as well as who the patient is, non-unions and fibrous unions occur approximately five percent of the time – similar to Tooth Implants failure rates.
The same principles that guide healing from a broken bone apply to healing an implant. You need good approximation of the bone surface to the implant surface and a period of immobility for successful osseointegration to take place. Osseointegration takes place when bone accepts and fuses itself to the implant, similar to how non-unions may fail when there isn’t proper bone healing after fractures. Instead of having bone surrounding the implant, you get fibrous encapsulation – just like how fibrous joints form during healing from broken bones – similar to how fibrous joints form during fractures.
Implant failure is frequently due to poorly managed diabetes and bone diseases, both congenital and acquired, as well as certain medications like glucocorticoids (prednisone), immunosupressants, bisphosphonate medicines (Zometa Fosamax Actonel Boniva Fosamax and Actonel), smoking or poor hygiene habits. Patients suffering from these conditions or taking these medications should bring these into the attention of their surgeon so they can create a personalized treatment plan tailored towards their individual needs and medical condition.
Other factors can also contribute to Tooth Implant failure. They may fail early during healing or later on during the process. Early failure is defined as any point before osseointegration (healing phase) occurs or when the crown is attached to the implant. Late failure refers to any time the tooth has lost its function and the implant no longer functions optimally.
Possible factors that could cause early failure include:
- When performing surgery, the bone can become overheated (usually due to lack of irrigation)
- Too much force when inserting implants (too snug fitting implants could actually cause bone resorption)
- Unfortunately, when implants are too loose they may not remain stationary and fail to heal correctly.
- Contaminated implant infection could have contaminated osteotomy epithelial cells at the osteotomy site (connective tissue, also referred to as scar tissue, fills in around the implant instead of bone).
- Poor-quality teeth may experience overly strong forces during osseointegration (when healing the implant is under function and mobile, so bone cannot attach to it), inadequate postoperative medication administration or other instructions, as well as implant rejection due to an allergic reaction to titanium alloy.
Poor oral hygiene is often to blame for late-onset dental failure. Unhygienic habits can lead to tooth loss in dental patients. Unfortunately, some people continue this bad habit even after receiving implant surgery – sometimes leading to overloading of the Tooth Implants uncommon. Certain patients are more vulnerable to bite forces and may require additional implants in order to distribute the pressure more harmoniously. Lateral forces can lead to implant failure if not placed axially – straight down and up like teeth do. When teeth, especially implants, are loaded lateral or tangentially they weaken the bone around them and may start to fail due to improper implant placement, insufficient bone volume or a poorly designed prosthetic tooth or device. Another potential cause may be an inadequately planned placement of the implant or improper prosthetic device design. Implants can fail for various reasons; some of which are preventable while others cannot. How can patients protect their chances of avoiding or reducing the chances of a failed implant? The most important way they can help themselves is by staying up to date on medications and instructions before and after the procedure, as well as taking advantage of this time to quit smoking.
To maximize the chances of successful outcomes with implants, it’s essential to find an experienced surgeon and dentist. Look for someone in Periodontists or Oral Surgeons whose specialty includes implant surgery; most times these surgeries are done as a group. Before choosing any surgeon for your implant procedure, be sure they are certified. Likewise, check the qualifications of any dentist who will repair (put tooth into implant) on top. Don’t be afraid to ask lots of questions! Request before-and-after images as well as testimonials from past patients to gauge other people’s experiences.
Implantology (the placement of dental implants) can be a complex and technically demanding procedure. Experience and an effective plan are paramount to success, while knowledge in your chosen field makes it even more valuable. Make sure your surgeon is board-certified in implantology and how long they have been doing so. Additionally, inquire if they collaborate with restorative dentists.