Soong-Ryong Jung (David) , DDS, MS, PhD
What Happens When a Dental Implant Fails?
What Happens When a Dental Implant Fails?
Dental implants are an expensive procedure that takes planning, time, and skillful execution. But even the best-laid plans and top-notch execution can sometimes go awry. According to a published estimate from Clinical Implant Dentistry, "The long-term failure rate of dental implants is generally 5-10%." Complications happen. Whether it is on the part of the surgeon, or the patient, or some factor outside of both their control. Sometimes, dental implants just fail. But what does that sort of failure look like? Is it something that only happens in one way, or are there multiple reasons why an implant wouldn't work for a patient? And what can dental surgeons do to mitigate it? Let's find out by looking at what experts say on the matter.
Dental Implants and Osseointegration
There is a term that dental surgeons use when an implant fails to assimilate or heal into the bone. Implants, in general, are made with a titanium implant body that is inserted into the bone, or an abutment. The abutment specifically uses the metal titanium. This is because that specific metal is not only non-poisonous, but it can fuse into the small spaces inside bone. This process is osseointegration. According to Wikipedia, "Titanium's ability to withstand the harsh bodily environment is a result of the protective oxide film that forms naturally in the presence of oxygen. The oxide film is strongly adhered to, insoluble, and chemically impermeable. This prevents reactions between the metal and the surrounding environment."
While titanium can naturally fuse into bone, there are some instances where that does not happen. Either because there is not enough bone for the titanium to attach. Or, there is something that is blocking the adhesion process. So, how does someone, who is not a professional dental surgeon recognize when an implant is not osseointegrating?
Recognizing a Failing Implant
For argument's sake, let's say you get a dental implant in Plano, Texas and you go through about two to six months of recovery. You have been keeping it clean to the best of your knowledge. However, whether it is immediately after the healing period or a few years later, you start to notice the implant wiggling. You may have a situation where the implant has not bonded well into the bone. Just like a loose tooth, if you notice it wobbling and or moving when you are chewing or talking, there is a good chance that the implant is not attached to the bone. But usually, if it is subtle, then you won't notice it alone.
A dentist or an oral surgeon will be more likely to pick up on how loose it is with an x-ray. Especially if it is a subtle issue. However, if the implant has totally failed, you are much more likely going to notice the movement. An X-ray of a failed implant will likely show significant loss of bone around the metal portion.
There is also a chance that you feel excess irritation, pain, and swelling in the gum line or jaw at the location of the implant. However, that is not often the case. Unless the implant is moving around, no one is going to immediately notice if the osseointegration failed. This does beg the question,
"Why do Implants Fail?"
There are two categories of implant failures, according to most dental surgeons, which range from short term to long term. Sometimes, the responsibility lies on the patient. Lack of proper dental care, smoking habits, or eating hard foods too early, can affect how the implant can bond into the jaw. Other times, it could be the fault of the surgeon. Implantation is a delicate procedure. If they do not have enough bone to work with, or accidentally place it near a nerve, then that implant will not take. Or at least wind up in the wrong spot.
There are situations in which there is no one to blame except for outside circumstances. For example, the patient could be developing rheumatoid arthritis or some other chronic condition that will naturally inhibit bone growth. There are even situations in which patients develop an allergic reaction to the implant. Or, their immune system decides to attack the area around the implant to prevent it from merging with bone.
That is why, when getting an implant it is important to be honest with your dental surgeon and to prepare for it.