There are two primary types of dental implant failures. Early implant failures occur due to problems with the procedure itself, or osseointegration, the process by which bone material grows around the abutment and integrates it into the structure. Late implant failures tend to be the result of other health factors as well as pressure placed on the prosthetic tooth.1
Teeth Grinding
Clinically referred to as “bruxism,” teeth grinding or gnashing can challenge the success of a dental implant. The pressure placed on the implant early in the process can affect osseointegration, causing instability and implant failure.1 Managing this condition may be critical in ensuring success of the tooth replacement.
Allergic Reaction
In rare cases, people have allergic reactions to the titanium used for the abutment. As the implant undergoes osseointegration, titanium ions may spread to surrounding bones and tissues. In those with sensitivity, this can cause:5
- Hives on the skin or in the mouth
- Eczema, redness, and itching on the skin or inside the mouth
- Swelling (edema) in the face or mouth
In severe cases, allergy to titanium has systemic effects, leading to necrosis (cellular death in the bone), neurological problems, chronic pain, and other issues.
Poor Impressions
The crown of the dental implant (the false tooth) needs to be perfectly matched to the surrounding teeth; there needs to be a perfect fit. Critical for this is that the dentist take a good impression, which is a cast that’s used to create a replica of your teeth.
If something goes wrong with this process, there’s a chance the prosthetic tooth will not properly fit into your mouth, which can cause a range of issues and lead to implant failure.
Infection
Infection of the gums around the dental implant, or peri-implant diseases, can also lead to failure. In a similar fashion to periodontitis, bacteria in the mouth form along the abutment at and below the gum line, eventually irritating and damaging the surrounding tissue.6
There are primary types of peri-implant diseases:
- Peri-implantitis mucositis: This is when there’s inflammation and infection only in the gums surrounding the implant. It’s characterized by redness and tenderness in these areas, and bleeding when brushing. It is generally treatable and reversible.
- Peri-implantitis: If allowed to advance, the infection can begin to affect the underlying bone structure as well. This significantly destabilizes the implant and is much more severe, requiring surgery to correct it.
Nerve Damage
If something goes wrong during dental implant surgery, surrounding nerves can become impacted or damaged. This can lead to persistent pain, numbness, tingling, or loss of sensation in the mouth. These cases may warrant work with an orofacial pain specialist, a dentist who specializes in pain disorders of the mouth, jaw, and face.
Implant Micromovement
Slight shifts in the position of the implant can also be a cause of failure. This happens during the period of osseointegration—which can take over two weeks—as the abutment remains mobile and susceptible to pressure.8 This instability can worsen and impacts the incorporation of the dental implant.
Bone Support Issues
The bone of the maxilla (upper jaw) or mandible (lower jaw) needs to be strong enough to support the dental implant. This essential bone material can weaken due to periodontal disease, trauma or fracture, tumors, and other health conditions. Insufficiency here can cause failure and warrants treatment.
Medical Conditions
Underlying conditions can also lead to dental implant failure, which is why a health evaluation is a necessary pre-requisite for surgery. Your body needs to be in good enough shape to take on the impact and recover from implantation.
Several factors increase the likelihood of complications and failure:
- Uncontrolled diabetes
- Osteoporosis
- Certain cancers
- Autoimmune diseases
- A history of radiation therapy on the head and neck
- Smoking
- Poor dental health; gingivitis and/or periodontitis
An Inexperienced Surgeon
When it comes to a complicated, multi-stage procedure like dental implant surgery, there isn’t a lot of room to make even small mistakes. Some dental implant failures are the fault of the oral surgeon, occurring due to poor placement of the abutment, or unintentional damage to surrounding tissues and bone.
Learn About Your Surgeon
Ask your surgeon about their experience with dental implant surgery and learn as much as you can about them. It’s worth weighing your options; a more experienced provider may be a better choice as they may be less likely to make mistakes.