Avoiding the risk of failure – Mr Luc Trevisan
Featured Products Promotional FeaturesPosted by: Dental Design 7th April 2018
Dental implants offer a permanent solution to irreparably damaged or missing teeth. Many implants will last a lifetime, or as long as a natural tooth will, if they are well taken care of. As with any other surgical procedure, however, there is a risk that some patients will experience complications with their implant. Although it is very rare, dental implants can fail. Practitioners need to be aware of the factors that can affect the long term success of implants, in order to be better prepared in case something goes wrong. A fast response enables practitioners to take corrective action before any additional and more serious problems can occur.
Generally, the success rate for dental implants is approximately 95%, which rises to 98% if they are cared for properly.[i]Despite this impressive track record, there is always a risk of problems. One of the most common causes of implant failure is the lack of fusion between implant and jawbone through osseointegration. If the implant does not osseointegrate correctly, it will not function as it should and could become loose, fall out completely or show signs of bone loss. According to Albrektsson et al., an implant is deemed a failure if there is bone loss of more than 1.5 millimetres after the first year of placement, and more than 0.2 millimetres every year after.[ii]Slight bone loss over several years is considered normal and should not affect the patient’s implant directly.
Before an implant can osseointegrate, the patient must have sufficient bone quality and quantity. Patients who suffer from diabetes, osteoporosis or a poor immune system are more at risk of bone loss because they already have weak bones.[iii]For patients who lack adequate bone height, width or length, bone grafting may be required to ensure they have a solid bone mass that will support osseointegration. If a bone graft is necessary, it will almost invariably increase the length of treatment time. However, when successfully applied, it will greatly improve the overall aesthetic and functional outcome of the implant placed.[iv]
Peri-implantitis is another common cause of dental implant failure. If it is left untreated, this inflammatory disease can damage the gingiva, resulting in deterioration of the bone structure supporting the implant. When this occurs, the implant must be completely removed and replaced. Just as with natural teeth, brushing and flossing, combined with periodic professional cleanings, are critical to preventing peri-implantitis.[v]Patients who are diabetic, smoke, or have a thin gingival biotype are more vulnerable to the infection.vSmokers, in particular, are more at risk of developing infection because nicotine is a vasoconstrictor that reduces blood flow, resulting in tissue ischemia and impaired healing of injured tissue.[vi]
It does not often happen but an implant can be placed too close to a patient’s nerves, thereby damaging them and causing chronic pain, tingling or numbness in the cheek, gums, tongue, lips or chin. The nerve damage could be temporary or permanent, and the implant may need to be removed as a result. In almost all cases, this problem is caused by mistakes made due to inexperience or poor treatment planning.[vii]Therefore, practitioners must have the relevant training and qualifications – as well as a careful treatment plan – in order to carry out quality implant treatment.
Although it is very rare, some patients can have an allergic or inflammatory reaction to the metal components in dental implants, with symptoms ranging from a tingling or burning sensation to swelling, oral dryness, loss of taste or even Chronic Fatigue Syndrome – patients may need to undergo a MELISA (Memory Lymphocyte Immuno Stimulation Assay) test to detect any allergy or sensitivity to metals.[viii]
While an implant is engineered to be durable and robust, it does have a breaking point. An implant can crack or fracture because of overloading – which could be a sudden impact like a blow to the face, or undue pressure through tooth grinding or bruxing over a prolonged period of time. These forces can easily disrupt the osseointegration process, resulting in implant failure.[ix]That is why practitioners must use the most superior implant systems to ensure the very best outcome.
TBR’s Z1 implant system from Dental Express, for example, is designed and manufactured to ensure long-lasting aesthetic results. With a 98.6% success rate, the Z1 implant is a unique system in that it combines zirconia and titanium in one seamless component – the high biocompatibility of these materials maximises soft tissue healing, promoting better osseointegration and reducing the risk of the patient developing peri-implantitis.
The success of dental implant treatment is dependent on a variety of factors, including the reliability of the implant system, it’s ability to fuse to the bone, as well as the patient’s compliance in maintaining good oral hygiene post-treatment – patients that look after their implant are more likely to lengthen its lifespan or, at the very least, avoid developing serious problems.[x]With a superior solution and follow-up maintenance, patients can enjoy the benefits of dental implants for a lifetime.
For more information visit Dental Express at www.dental-express.co.uk, call 0800 707 6212 or learn more about the Z1 implant at http://z1implants.co.uk/and the full range of implants at http://dental.tbr-implants.com/en/
[i]The Dental Implant Guide. (2018) Dental Implants Have Long-Term Success. Link: http://thedentalimplantguide.org/dental-implants/why-dental-implants/long-term-success/. [Last accessed: 05.02.18].
[ii]Rasouli Ghahroudi, A., Talaeepour, A., Mesgarzadeh, A., Rokn, A., Khorsand, A., Mesgarzadeh, N. and Kharazi Fard, M. (2010). Radiographic Vertical Bone Loss Evaluation around Dental Implants Following One Year of Functional Loading. Journal of Dentistry (Tehran, Iran), 7(2), 89–97. Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3184744/.[Last accessed: 05.02.18].
[iii]Chen, H., Liu, N., Xu, X., Qu, X. and Lu, E. (2013) Smoking, Radiotherapy, Diabetes and Osteoporosis as Risk Factors for Dental Implant Failure: A Meta-Analysis. Link: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0071955. [Last accessed: 05.02.18].
[iv]Association of Dental Implantology. (2018) Considering Dental Implants? Bone grafting. Link: http://consideringdentalimplants.co.uk/considering-dental-implants/placement2.html. [Last accessed: 05.02.18].
[v]Perio.org. (2018) Peri-implant Diseases. Link: https://www.perio.org/consumer/peri-implant-disease. [Last accessed: 05.02.18].
[vi]Silverstein, P. (1992) Smoking and wound healing [Abstract]. Am J Med. 93(1A):22S-24S. Link: https://www.ncbi.nlm.nih.gov/pubmed/1323208. [Last accessed: 05.02.18].
[vii]Dental Implant Cost Guide. (2018) 8 Dental Implant Problems & Causes of Failure. Link: https://www.dentalimplantcostguide.com/problems/. [Last accessed: 05.02.18].
[viii]Sidi, A. (Unknown) Implant Failure: Treatment by Top Implant Surgeons. Link: http://www.implantperio.net/stand-alone/dental-implant-failure. [Last accessed: 05.02.18].
[ix]Beautysetter. (2018) Dental implant problems and complications: what can go wrong? Link: https://beautysetter.com/dental-implant-problems-complications. [Last accessed: 05.02.18].
[x]Association of Dental Implantology. (2015) Considering Dental Implants? A patient’s guide to dental implant treatment. Link: http://consideringdentalimplants.co.uk/considering-dental-implants.pdf. [Last accessed: 05.02.18].
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