Patients who smoked experienced significantly higher dental implant problems, resulting in poorer success rates. The rate of an implant's success is related to operator skill, quality and quantity of the bone available at the site, and also to the patient's oral hygiene. Various studies have found the 5 year success rate of implants to be between 75-95%.
Most implant problems resulting in implant failure can most often can be related to the implant's inability to osseointegrate correctly. A dental implant is considered to be a failure if it is lost, mobile or shows peri-implant bone loss of greater than one mm in the first year after implanting and greater than 0.2mm a year after that.
Dental implants are not susceptible to dental caries, but they can develop a periodontal condition called peri-implantitis due to poor oral hygiene. As noted above, the risk of failure is also increased in individuals who smoke. For this reason, due to the expenses involved, in order to minimize dental implant problems, the dental implants are placed only after a patient has stopped smoking and often refer them to smoking cessation programs. More rarely, an implant may fail because of poor positioning at the time of surgery, or may be subjected to too much force, failure to integrate.
The following video shows a patient whose implant needed to be removed. 10% of all dental implants placed will failed in 4-5 weeks,the implant will be mobile, gum redddish & swollen, pain when touched. The cause usally is related to the quality of bone at the implant site, eg. from previously infected tooth. The implant need to be removed, implant socket "cleaned" and new implant re-inserted after another 4-6 weeks.
There are no absolute specific situations where a dental implant procedure has shown to be harmful to a patient. According to the American Academy of Implant Prosthodontists, implants are made of biologically compatible materials which have undergone extensive testing over a period of several years. The materials used are largely metals, such as titanium, and have never been living tissue. Therefore, there exists no likelihood that an antigen-antibody response would cause a rejection similar to that which sometimes occurs with heart and kidney transplants. There are, however, some systemic, behavioral and anatomic issues that should be considered when discussing dental implant problems. They involve the issues of Type II Diabetes, the use of bisphosphonates and a condition known as bruxism.
Uncontrolled type II diabetes is a significant relative contraindication. Healing following any type of surgical procedure is delayed due to poor peripheral blood circulation. Anatomic considerations with type II diabetes also include the volume and height of bone available. Often an ancillary procedure known as a block graft or sinus augmentation is needed in order to provide sufficient bone for a successful implant placement.
Bisphosphonates is taken for osteoprosis and certain forms of breast cancer. The use of bisphosphonates puts patients at a higher risk for developing a delayed healing syndrome called osteonecrosis. Therefore, dental implants may be contraindicated in patients who are currently taking this drug.
Bruxism involves the grinding and clenching of teeth. The forces generated during bruxism can be detrimental to implants, particularly, while bone is healing. This is due to the micromovements occurring in the implant positioning, which is also associated with increasing the rate of a dental implant problem, thereby increasing the rate of an implant failure. Bruxism will pose a threat to dental implants throughout the life of the recipient. While the natural teeth contain a periodontal ligament which allows the tooth to move and absorb shock in response to vertical and horizontal forces, dental implants do not have this ligament. The tooth of an implant is immovably anchored into the jaw bone. The condition of bruxism can be minimized by the use of a custom made mouth guard.
While specialists such as oral and maxillofacial surgeons or periodontists often play a role in the placement of implant fixtures, it is important that a general dentist or prosthodontist initiate and coordinate the process. They can best assess the merits of a dental implant against other prosthetic devices.