Dental Implant Failure

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What are Dental Implants?

Dental implants are an excellent solution for tooth replacement. For millions of people who are missing one or more teeth, it can affect how they speak, eat, and smile. 

Implants are the closest replacement to a natural tooth. The implant acts as the tooth root and a dental crown replacing the existing tooth.

jaw with teeth and dental molar implant

Besides being the most permanent option to replace a missing tooth, dental implants also serve many aesthetic and functional needs like:

  • Implants support your existing jawbone and gums from further receding and deteriorating 
  • Implants are the most natural-looking restorations
  • Implants restore permanent tooth function with no mobility like a denture
  • Implants are tooth decay “free,” meaning they can’t develop new cavities like dental crowns
  • Implants help maintain a more youthful appearance by filling in the jaw and face

What is the Failure Rate of Dental Implants?

There is no guarantee with any dental procedure. Dental implants, like any dental treatment, can fail. However, among the range of dental prosthetics, implants have one of the lowest failure rates.

The implant failure rate is around 5%. Studies show that only 1 in 20 patients may experience dental implant failure. Compared to most procedures, this is a low failure rate, and dental implants are usually worth the risk. 

Why Do Some Dental Implants Fail?

The dental implant success rate is rather high compared to other dental procedures at approximately 95%. Still, dental implants can fail for a variety of reasons. 

It is important to discuss reasons for failure with your dental professional before implant placement. Implants are a costly and timely investment, and while beneficial to your oral health, it is best to know common reasons for failures and how to prevent them. 

The most common reasons for dental implant failure include:

  • Bacterial infection. A dental infection is the most common reason for implant failure. Peri-implantitis can result from poor oral hygiene and cause bone loss around the titanium implant, leaving it unanchored to the jawbone. Unfortunately, it can happen at any time, but it is more likely to develop soon after the surgery. Placing an implant incorrectly without enough bone support is a leading cause of peri-implantitis.
  • Premature loading. Sometimes, the dentist or patient is in a rush to get a dental prosthetic attached to the implant. When this occurs, it may jeopardize the osseointegration process. Instead, you should wait until the surgical site is properly healed until you get your new restoration. 
  • Insufficient bone support. Without enough bone support, a dental implant cannot successfully integrate with your jawbone. Many people need a bone graft or sinus augmentation to improve bone density. Bone grafting is much more successful when the graft is from the patient than from a donor. 
  • Bruxism. If you are a constant grinder, it is important to discuss this with your dentist before surgery. Continuous grinding and clenching can cause stress on a new implant and may interfere with healing and osseointegration. 
Dental attrition (Bruxism) resulting in loss of tooth tissue. Medically accurate tooth 3D illustration

What are the Signs of Dental Implant Failure?

There are early and late signs of dental implant failure. If you recently had implant surgery, you may notice signs indicating the implant is not successfully osseointegrating. 

Implant failure can also occur even ten years after placement. 

Osseointegration is an integral process that ensures the implant is successfully anchored and integrated into the bone. Without osseointegration, there is no long-term success of the implant, and it can fail.

Common signs of failing implants include:

  • Gum inflammation and swelling
  • Gum recession and tissue loss
  • Bleeding
  • Mobile dental crown or implant
  • Severe pain when chewing

What Factors Influence Dental Implant Success?

Prior to choosing a dental implant to replace a missing tooth, it is important to discuss all factors that may impact your implant’s success. There are several reasons that can cause an implant to fail, and an experienced dentist will review these factors prior to surgery to ensure you are a proper candidate.

There are several factors to consider before deciding on treatment options. Some important things to consider when making a decision may involve your medical history or lifestyle.

The most common risk factors for implant failure include:

  • Smoking. People who use tobacco products have a significantly higher risk for implant failure than non-smoker or tobacco users. This is because tobacco can affect blood flow and the healing process.
  • Poor oral hygiene. If you have a history of periodontal disease, this can affect your implant success. Gum disease is associated with bone and tissue loss. For your implant to successfully osseointegrate, you need to care for your gum health by brushing and flossing regularly and attending routine dental visits. 
  • Uncontrolled medical history. Those with an unstable medical background like osteoporosis, diabetes, cancer, or an immunodeficiency may not be the best candidates for dental implant.

Other reasons a dental implant may fail may be due to chronic grinding, a bone graft failing, leading to less support of the implant, or rushing the implant crown process. 

How to Prevent Dental Implant Failure

The best way to prevent an implant failure is to plan your treatment out with your dentist in advance. Many dentists plan very tediously to ensure the treatment goes well. Some use advanced 3-D technology to create surgical guides so that an implant is placed precisely to prevent failure.

Speak to your dentist about any smoking or alcohol habits and disclose your full medical history and medications. Discuss any concerns you may have that can cause a potential implant failure and how you can plan to prevent one. 

Follow your dentist’s aftercare instructions by abiding by a soft food diet, avoiding smoking, and maintaining excellent oral hygiene. Also, make sure to plan for follow-up appointments.

When to See Your Dentist

A few days after your dental implant surgery, you will schedule a follow-up to ensure you’re healing properly. An x-ray can be used to help clinically determine an implant’s success too. 

Once your implant and crown are placed, you should schedule routine exams with your dentist to maintain good oral health.

If you experience severe pain, bleeding, swelling, implant mobility, or fever, you should contact your dentist for an emergency visit. 

Treatment for a Failed Dental Implant 

When a dental implant fails, it needs to be removed. There is an underlying reason why the implant failed, and it needs to be addressed. Often, the implant failure is because of bone loss and peri-implantitis, leaving the implant loose or infected. It can be traditionally removed similarly to tooth extraction and at times needs to be surgically removed. 

Once a failed implant is removed, your gums and bone need time to heal. It can take up to 6 months or more for the area to heal properly before another implant can be placed. Depending on the site of the implant, you may need additional surgery like a bone graft or sinus augmentation for more support and stability. 

Usually, once the reason for the failed implant is discovered, a new implant can be placed and have a high success rate. If you are not a good candidate for another dental implant, you may be eligible for a dental prosthetic like a bridge or removable appliance. 

Risks of Not Fixing a Failed Dental Implant

A failed implant can occasionally happen, but neglecting to remove it or replace it can have oral health ramifications. Unlike teeth which have nerves and can signal when there is pain, an implant does not have any nerves or blood vessels. Instead, when there is an infection, your implant may become mobile, causing pain and bone loss.

Without fixing a failed dental implant, it can lead to localized and generalized inflammation and infection. This may cause significant bone loss leading to poorer success for implants in the future. An infection may also require antibiotics to avoid systemic infection and medical complications. 

How Much Does it Cost to Fix a Dental Implant?

The cost of implants varies significantly based on how many implants and the type of dental restoration you have. Unfortunately, dental implants are not a guaranteed success. If it fails, you may be responsible for replacing it at near or the same cost as your initial investment.

Many dentists will discuss their fees upfront, so you are aware of the costs if you need to fix a dental implant. 

Can I Get a Refund?

If an implant fails because of the dentist’s error, you may be entitled to some refund. Otherwise, if it fails because of poor oral hygiene, a smoking habit, or an uncontrolled medical condition, you are responsible for the costs of fixing your implant.

Resources

Palmer, R. Introduction to dental implant. Br Dent J 187, 127–132 (1999). https://doi.org/10.1038/sj.bdj.4800222.

Pyo S-W, Lim Y-J, Koo K-T, Lee J. Methods used to assess the 3D accuracy of dental implant positions in computer-guided implant placement: a review. J Clin Med. 2019;8:54.https://www.mdpi.com/2077-0383/8/1/54.

Putra, R.H., Yoda, N., Iikubo, M. et al. Influence of bone condition on implant placement accuracy with computer-guided surgery. Int J Implant Dent 6, 62 (2020). https://doi.org/10.1186/s40729-020-00249-z.

A guide to implant dentistry part 2: surgical and prosthodontic considerationsDespoina Chatzistavrianou, Paul HR Wilson, and Philip Taylor Dental Update 2019 46:6, 514-523 https://doi.org/10.12968/denu.2019.46.6.514.

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