Tooth Implants What determines Success and Failure

Tooth Implants What determines Success and Failure

Tooth Implants can be offered to patients as a complete or near replacement for teeth that are missing. Patients are rarely informed about the risks involved and are not advised about the likelihood of failure. The procedure can have severe negative consequences and aren’t 100% effective. Implants are susceptible to failure and fail frequently. Patients need to be thoroughly informed about the risks and understand the fact that the tooth Implants could fail. Implant placement can be made safe, predictable and beautiful if done correctly.

Tooth Implants are a huge way from their early 1950’s conception. Tooth Implant technology changes at an astonishing pace. The effectiveness of tooth implants is generally improved with each new technology. Sometimes, a new technology that has great marketing doesn’t help or hinder its success. It’s not a common occurrence.

What causes Tooth Implants to fail? There are many factors that lead to an increased risk of Tooth Implant failure. However, some of the risk factors aren’t avoidable, which is the reason Tooth Implants are about 90-95% successful based on various studies (the number is actually close to 95%). There are some fractures that do not heal even with the greatest estimation and with the highest level of immobility. Non-union (meaning that healing hasn’t begun) or fibrous union (where there’s scar tissue in place of bone between the fractures) may occur. Depending on the type and the location of the fracture and the patient, non-unions as well as fibrous unions occur about five percent of the time. Similar to the failure rate for Tooth Implants.

The same principles of healing from a fracture can be correlated to the healing process of implants. To ensure osseointegration is successful it is crucial to align the bone to the surface of the implant. Osseointegration is when the bone accepts the implant and fuses itself around it. As you can see, the failure rate of implants is similar to fractures not healing properly. It is possible that the bone fail to join, just like non-unions. Instead of having bone around the implant, you receive fibrous capsules. It is similar to the fibrous joint seen in bone fractures.

Certain conditions that increase the risk of implant failure are poorly managed diabetes, certain bone metabolic and congenital disorders Certain medications, such as glucocorticoids (prednisone) as well as immunosupressants, and bisphosphonate medicines (Zometa, Fosamax, Actonel, Boniva, etc.) Smoking and poor hygiene practices can increase the chance of implant failure. Patients who are taking these medications should inform their implant surgeon to ensure an appropriate treatment strategy.

Other factors can lead to an increase in Tooth Implant failure. Implants may fail early during the healing process or late. Early failures would be defined as any time before the osseointegration process takes place (healing phase) or at the time the crown is fixed to the implant. Late failure refers to any point at which the tooth has lost its function and the implant is not in good condition.

Early failure is often caused by:

The failure type is usually observed soon after the implants are placed. These are caused by:

  • The bone is overheated during the procedure (usually because of inadequate irrigation)
  • A lot of force is required for the placement of these implants (too snug fitting implants could cause bone to resorb).
  • Not enough force to hold them in place (too loose fitting implants can remain stationary and heal correctly)
  • Contaminated implant infection contaminated osteotomy epithelial cells within the osteotomy sites (connective tissue, also known as scar tissue fills in the space around the implant instead of bone)

Bone of poor quality

Excessive forces during osseointegration. (during healing, the implant is under functioning and it is not mobile, and bone isn’t able to connect to the implants). Poor compliance with post-operative medication and/or instructions Tooth Implants are not uncommon, and can result in rejection of the implant because of a titanium alloy allergy.

A lack of hygiene is a frequent reason for late failures. Insufficient hygiene could lead to dental patients losing teeth. Some individuals continue with this behavior even after they have had implant surgery. Sometimes, the implant could be simply too heavy. Some patients have greater forces of bite and might have needed more implants to distribute forces more evenly. Implants that are lateral can cause them to fail later. Implants and teeth prefer to be loaded straight up or down, also known as axially. Implants and tooth that are loaded laterally or tangentially can weaken the bone and cause them to fail. Another cause is the poor placement of implants or placement that is not correct, or inadequately designed prosthetic teeth, teeth, or device. Implants can also fail for numerous reasons. Some of these issues are easily avoided or controlled however others are more difficult to eliminate. So how can a patient best ensure they are protected and decrease the chance of implant failure? Patients can be as strict as they can be with their medication and follow all instructions. The second is taking this chance to quit smoking.

However the most controllable factor to ensure the highest chance of success is finding the ideal surgeon and dentist. Choose an experienced implant surgeon. This specialty includes Oral Surgeons and Periodontists. Implants are usually performed in a team. You must ensure that not only your implant surgeon is qualified, but also just as important is the qualifications of the dentist who will restore the implant (putting the tooth on implant). Ask many questions. Ask for photos of before-and-after photographs and ask about the opinions of patients.

Implantology (placing of implants) is a complicated and technical process. The success stems from proper preparation of the case, and also the knowledge, training and experience are the main factors to the success of the procedure. Although training is important, having knowledge in the field of your interest can make it even more effective. Ask your dentist if they are board certified and for how many years they have been placing implants, and if they regularly work is done or if they have a relationship with restorative dentist.

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