Tooth Implant Success and Failure: What Determines Success and Failure?
Tooth Implants can be presented to patients as the perfect or similar replacement for missing teeth, but they often lack informed of the risks and are warned about potential failure rates. Although procedures like these have serious potential effects and aren’t always successful, patients must be made aware that Tooth Implants do happen – patients must understand and accept that failure is possible. With proper planning and preparation though, implant placement can be secure, predictable and provide both aesthetic and functional benefits for patients.
Tooth Implants have come a long way since their 1950’s inception. Technology continues to advance at an amazing rate, often leading to greater success with each new advancement. Unfortunately, sometimes well-marketed innovations don’t always yield positive results – fortunately this doesn’t happen too often.
What Causes Tooth Implant Failure? Tooth implant failure is more likely when several reasons are taken into account, though some risk factors cannot be avoided. As a result, Tooth Implants typically have an impressive 90-95% success rate according to studies (the actual number closer to 95%). With long bone fractures, even with accurate approximations and extensive immobility, some fractures cannot heal after casting is taken off. No union occurs (meaning healing never began) or fibrous unions take place (where instead of bone on both sides of the fracture you find scar tissue). Fibrous or non-union rates can range up to 5 percent depending on the nature and location of a fracture; this rate is similar to what happens with Tooth Implants when they fail.
The principles of healing a broken bone are also compatible with implant healing. To achieve successful osseointegration, it’s essential that the bone match the surface of the implant precisely. Osseointegration occurs when bone takes in and fuses itself to it; failure rates for implants can be similar to fractures that don’t heal correctly; instead of having bone surrounding the implant, you might see fibrous encapsulation similar to what occurs with non-unions in fractures.
Implant failure may be caused by poorly controlled diabetes and bone diseases – either congenital or acquired – as well as certain drugs like prednisone (glucocorticoids), immunosupressants and bisphosphonate medicines like Zometa Fosamax Actonel Boniva Fosamax Actonel etc. Additionally, poor hygiene habits and smoking increase the chances of implant failure. People with these disorders or taking these medications must bring these to the attention of their implant surgeon so they can create a treatment plan tailored towards their individual needs and medical conditions.
Another potential cause of Tooth Implant failure is an early or delayed failure during the healing process. An early failure refers to any time before osteointegration (healing phase) takes place or when the crown is attached to the implant; while late failure refers to any time after both implants and teeth have been in operation.
Early failure can be due to:
Implant failure may occur shortly after placement and be due to:
- When performing surgery, the bone can become overheated (usually due to inadequate irrigation). Too tight-fitting implants may lead to bone resorption.
- Not enough force to hold them in place (too loosely fitting implants won’t stay stationary and heal properly)
- Contaminated implant infection contaminated osteotomy epithelial cells at osteotomy sites (connective tissue, commonly referred to as scar tissue fills the socket around the implant instead of bone)
Bone of poor quality
Tooth Implants have a higher failure rate due to inadequate healing, an excess of mobile bone around the implant, and inadequate postoperative medications or instructions. Unfortunately, some people develop allergies to titanium which can lead to implant rejection and lead to further problems.
Late failures often stem from poor hygiene on the part of the patient. Bad hygiene can lead to tooth loss, and some individuals continue this practice even after having had implant surgery. Furthermore, sometimes an implant may be too heavy for comfort. Certain patients are more vulnerable to bite forces and may require additional implants in order to distribute the stress more evenly. Lateral forces can lead to implant failure prematurely; instead, implants and teeth should be loaded axially – straight up and down. Implants and teeth which are loaded laterally or tangentially may weaken bone and fail. Another possible reason could be improper placement of implants or improper installation; or an inadequately designed prosthetic tooth, teeth, or device. Therefore, implants can fail for many reasons; some of which are preventable and controllable while others are beyond our control. How can patients best safeguard their chances and reduce the likelihood of a failed implant? The most important step they can take is staying compliant with medications and instructions both before and after their procedure. Secondly, stop smoking to help reduce smoking related risks as well.
However, the most crucial element for ensuring successful outcomes is finding an experienced surgeon and dentist. Look for oral surgeons, periodontists and general dentists with advanced post graduate training who have achieved great success with implants. Implants tend to be done in groups so it’s essential that your implant surgeon be qualified. Furthermore, ask about photographs of before and after photos as well as opinions from other patients. Ask lots of questions so that all details are clarified.
Implantology (the placement of implants) can be a complex and technical procedure. To ensure its success, an organized and experienced team is necessary. Training is important, but having substantial expertise in your research field makes it even more advantageous. Make sure your surgeon is board-certified and how long they have been placing implants as well as if they do regular procedures or even communicate with restorative dentists.
