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Why do implants fail?
As with any medical procedure there are risks involved in dental implant surgery. The main risk is that the implant and bone do not fuse properly. Studies show that the main reason dental implants fail is that the quality and quantity of bone is not sufficient to successfully receive implants. In general the greater the bone density and quantity the more likelihood of success. Although sometimes bone can be overly dense which will provide great anchorage but limited vascularity.
Factors affecting bone density
The biggest risk of failure is with soft bone textures. Bone quality can improve around a functional osseointegrated dental implant due to positive bone stimulation. Generally speaking the human lower jaw has tougher and more dense bone than the upper jaw which has softer bone. Also denser bone is generally found at the front of the jaw bone. Bone density can deterioate for a variety of reasons such as:
- Residual bone (Alveolar Ridge) atrophy is where the jawbone recedes due to missing teeth which casues a lack of pressure on the bone. The rate varies from person to person but it can be measured through x-rays. Bone atrophy can change the shape of your face resulting in your face having a sunken appearance. Implants prevent atrophy by fusing with the bone stimulating it. Bone augmentation can be used to create an area to receive implants in cases where the bone has receded.
- Alveolar bone destruction due to periodontal disease - Periodontitis is casued by bacteria that result in a mouth infection and may affect up to 30% of adults over 30. We look at the effects of periodontal disease on dental implants in more detail here.
- Traumatic tooth extraction - If you are having a tooth extracted to prepare for a dental implant, it is advisable that the extraction is performed by an implant surgeon. This should avoid damaging the bone in the receptor area.
Smoking - There have been many studies done on the effects of smoking on jawbone density and healing after dental implants. These studies date back to the 1970′s and are not disputed. Smoking can cause bone atrophy. Smoking can cause periodontitis and makes it less likely that patients will respond positively to treatment for gum disease. Once the implant is placed smoking makes it more difficult for the implant and bone to bond. All of these factors make it more likely that implant operations for smokers will fail. The good news for smokers is that studies have shown giving up smoking will slow down bone atrophy and periodontitis. The American Academy on Periodontology believes that quitting smoking is similar to never smoking for periodontal therapy.
Other risks
Other risks include temporary side effects such as swelling and discomfort and more seriously the risk of the implant damaging the nerve and sinus membrane. Over the counter pain killers such as paracetamol or ibubrofen should alleviate temporary discomfort, however be sure to read the instructions that come with the medicine and ask your pharmacist for advice if you have any questions.
It is very important that the implant does not interfere with the maxillary sinus membrane or mandibular nerves. Any problems here can have a lasting detrimental affect on the patients quality of life that go beyond their teeth. However, problems here are rare and the selection of a competent dentist will help safeguard this risk. The use of X-rays and CT scanning when planning the operation negates the risk of the implant coming into contact with the sinus membrane or nerves.
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