Dental Implants and Risk Factors for Failure
Dr. Alexander Corsair practices Periodontics in Rockville Centre, NY. In addition to his clinical practice he is an assistant clinical professor in periodontics at S.U.N.Y. He has written many scientific papers. Dr. Corsair has expertise in the treatment of oral inflammation and often treats problematic periodontal cases,... more
Millions of dental implants have been successfully placed in the past 30 years in the USA with a high success rate. There is a failure rate of 5% immediately after placement, to 20% 10 years down the road.
What are the factors that contribute to dental implant failure?
Let's start with a list:
- Smoking
- Bruxism (clenching or grinding)
- Drugs like steroids, bisphosphonates, Lexapro
- Poor oral hygiene and dental health
- Poorly controlled diabetes
- Poorly designed prosthesis
There are also anatomical factors like poor bone quality, insufficient bone height and width, and inadequate space for more implants. For example, two implants to help stabilize an upper denture is not going to be as successful as four implants. Also, if the patient wants a denture with no coverage on the palate, then 6 implants are required.
The best way to determine your risk factors is to see a specialist; perhaps a board certified dentist will be able to help best.
In order to determine the risk factors the dentist will need:
- A medical and dental history
- A clinical oral exam
- X-rays which often include a CT Scan, a scanning appliance, and models
There should also be an analysis of not only what teeth are missing, but also of what other tissues have receded (bone and gum tissue) and need to be replaced.
Depending on what has been lost, a prosthesis will be recommended. A full denture supported by implants will be appropriate when much tissue has been lost. Often, this prosthesis can be screwed down to the implants (4 to 8 implants) and may only be removed by the dentist.
In other cases where one or two teeth are missing, the dentist can place a crown and abutment post on each implant. So, the appropriate choice of prosthesis as well as expert fabrication will be a major factor in success.
The bottom line
Short term failures may be caused by:
- Smoking
- Poor bone
- Certain drugs
- Medical issues
Long term failures may be caused by:
- Bruxism
- A poorly designed prosthesis or bridge
- Excess cement retained under the gum after placement of caps on implants
What are some signs of developing problems?
Bleeding and or swelling of the gum tissue surrounding implants, looseness of the restoration, and pain or fracture of a part are signs of developing dental implant issues. An x-ray will usually show if the bone is normal or if some bone has been lost. Normal bone usually means the problem can be treated. If the abutment post is loose, it can be tightened. Bleeding is treated with scaling and improved oral hygiene. If the implant is damaged, it must be removed as soon as possible.
Most of my patients have had good experiences over my 30 years of placing dental implants. However, there is no guarantee except that I and most experts will try our best to help you with your problem of having lost teeth.
Dr. Alexander Corsair is a board certified periodontist doing dental implants for years in Rockville Centre Long Island. In addition to his clinical practice he is an assistant clinical professor in periodontics at S.U.N.Y. He has written many scientific papers.
