Failed Dental Implants Reconstructive Dentistry
Cause and Effect Factors in Implant Dentistry
Dental Implants are considered to be the Gold Standard of tooth replacement. No other dental technology approaches the efficiency and accuracy of an implanted tooth and the benefits derived from it. The artificial root structure is second only to Mother Nature herself.
Hard and soft tissue stimulation created by the implant device preserves critical bone mass and sustains life in surrounding tissues. Properly implemented and without complication they can provide years and years and years of dependable service. Implants enduring for 35 years and more is not unheard of.
Early Preliminary Diagnosis is Critical
Repairing Restorative Component Failures
An accurate diagnosis should be obtained as soon as an implant is suspected of failure.
|Zirconium Crown Abutment
A restored implant may be loose, wobbly or create pain symptoms due to a failure in the restoration itself which can involve abutments, thread devices within certain types of implants, broken threads or perhaps a loosening of the abutment materail (e.g., zirconium).
Repairs and replacements of restorations can usually be completed quickly, returning the implant tooth to the normal occlusal relationship that was designed into the original treatment. Extended delays in completing the restorative repair does pose some functional risk for adjacent tooth structures, depending on treatment history.
Implants used in bridgework that are suspected of failing will affect the entire bridge structure and should also undergo differential diagnosis asap (see picture below).
Implant Device Failure
An implant that is perceived to be failing or has gone bad due to a breakdown of the osseointegration that occurs within the jawbone-implant device relationship should be differentially diagnosed as soon as possible or feasible.
While root form implants are known for their healthful bone stimulating qualities..... that healthy benefit exists only when osseointegration is "text book perfect". Implant technology is unsurpassed in maintaing healthy jawbone that prevents common resorption.
A loose implant with a faulty osseointegration (i.e., osseointegration no longer exists) becomes an agent of trauma that can initiate accelerated bone loss and jawbone damage in the immediate treatment area.
|Two Piece Tapered
Repairing an implant that has gone bad due to the loss of the fused state between the jawbone and implant device can involve one or more combinations of: a change in implant design, additional bone grafting, a change in type of bone graft material used (e.g., pulverized vs chin block or ramus, changing occlusal relationship (restoration height or width), etc.
Anatomy of Implant Failure
The causes or reasons for dental implant failure are quite complex and can even be confusing.
Implants that fail quickly, or early.... generally have causal factors that may be related to errors in treatment planning, matching of technologies to given tissue conditions or inadequate analysis of the best treatment option (unlike restorative dentistry.... which offers multiple choices of aesthetics and function - implant surgery typically offers only one best choice (highest predictability of success).
This type of failure occurs shortly after the implants are placed. They can be caused by:
- poor quality of bone
- insufficient bone grafting (if used)
- ineffective grafting technology choice
- epithilial cells in osteotomy site
- contaminated osteotomy
- contaminated implant
- overheating the bone
- too much force when they are placed
- not enough force when they are placed
- excessive forces during osseointegration (chewing, biting)
- a myriad of other reasons
Implants that become wobbly, loose or fall out after a significant period of optimal function typically result from excessive forces on the implant... which most commonly arises out of a shifting bite or changes in the vertical dimension (normal height of upper and lower jaws in the resting position).
Adjacent, normal teeth wear differently from a porcelain restoration. A perfectly placed and functional implant can fail in the future if the the occlusal relationship between the implant tooth and natural teeth is not monitored (routine checkups should never be minimized). Teeth clenching, in particular, should be monitored on a routine basis.
If a bite - occlusal relationship should change, it is possible that opposing biting forces can become redistributed to the extent they create a lateral force that exerts pressure horizontally, something a dental implant is not designed to withstand.
Implant Supported Bridgework
Implants used in bridgework offer excellent choices in multiple tooth replacements that are affordable and provide excellent dental cosmetics.
Maintaining good oral health with bridgework does require the practice of routine hygiene habits.
|A Once Upon A Time Premium
Implant Supported Bridge
|Delayed Treatment Destruction
While anchor teeth that are implant supported are superior to cemented bridgework (bridge is mounted on natural anchor teeth), poor habits can lead to an accumulation of bacteria and eventual infection.
The adjacent pre treatment photos of bridgework show the extremes of failure that was initiated by an implant failure.
First, the restoration of the implant device fails and falls off... leading to occlusal forces that shift and, over time, damage the remaining bridgework.
Notice the degree of discoloration, apparent seepage of bacterial contaminants and occlusal damage to nearly every tooth in the bridgework. Early diagnosis and timely treatment of the failed implant could have prevented this amount of damage.
Anyone suspecting an implant failure... for whatever reason, should make arrangements for an immediate diagnosis to determine the type of failure and Dr. Nazarian's implementation of steps to control or eliminate the threat of any additional tissue or tooth damage.
Call our office at (248) 457-0500 to arrange a consulation. Dr. Nazarian is also available via our on-line Ask the Dentist form for any special questions or information needs related to the complications of failed implant dentistry. Dr. Nazarian will respond directly to your email.