Treating Dental Implant Failure

Although dentists and patients typically do all they can to avoid implant failure, it can sometimes still occur. Occasionally, though, dental implant failure can result from dentists and/or patients seeking a cheaper or easier method or solution. Here are some examples of these causes:

Taking “shortcuts” during the diagnostic phase – Although a two-dimensional panographic x-ray can be sufficient in many types of oral surgery, it is not preferable for planning proper dental implant placement. When placing dental implants, many things that must be considered require a three-dimensional view. These can include:

  • Determining if the patient has an adequate amount of bone available to support the implants
  • Understanding the exact shape of anatomical structures, such as the patient’s nasal sinuses
  • Locating the nerves and blood vessels within the bone

To obtain an accurate level of information when planning these complex cases, Dr. Chal believes that carefully executed CT scans are imperative, and that these scans should be analyzed by a maxillofacial radiography specialist. Although these 3-D CT scans are intricate and informational, they take less than three minutes to complete, and the radiation exposure to the patient is extremely minimal – less than 3% than that of a traditional medical CT scan. Dr. Chal then takes these 3-D scans and prints out one-millimeter cross-sections of the patient’s jaw. This helps Dr. Chal to see the the thickness and quality of available bone, as well as the exact locations of blood vessels and nerves.

Incomplete medical history – The success of dental implant treatments can be affected by a number of medical conditions. Without proper knowledge of a patient’s medical history, appropriate action might not be taken, leading to a higher potential for implant failure. This misstep can be avoided with thorough research and care from the dentist.

Substandard dental implant fixtures – While there are hundreds of dental implant manufacturers out there, not many of them pay to have their products tested through juried research, which documents the quality of these products. A great deal of these manufacturers cut costs by skipping these tests. This significant price cut may be attractive to some dentists, considering that a substandard fixture can sometimes be as little as one-one hundredth of the cost of a precision-engineered fixture. However, cutting corners to save money can often lead to negative consequences for the patient later on. The photograph above illustrates one way a cheap fixture can lead to dental implant failure. For more information, please see our page warning about cheap dental implants.

Incorrect dental implant placement – Implant placement is decided during the diagnostic phase of treatment, so when dental implants are improperly placed, it is often due to an inadequate diagnosis. However, this type of implant failure can also sometimes be the result of a lack of communication between the restorative dentist and the surgeon. Dr. Chal has encountered patients experiencing these types of dental implant mistakes, and has been able to prevent the problem from becoming worse. You may also be interested in reading about how incorrect dental implant placement became a painful and expensive case which led to the need for corrective surgery.

Types of Dental Implant Failure

These cases can be placed into four main categories:

This is a loose screw that Dr. Chal removed from a patient. She had a substandard fixture, the screw had become loose, and this allowed  an opening for infection.

This is a loose screw that Dr. Chal removed from a patient. She had a substandard fixture, the screw
had become loose, and this allowed
an opening for infection.

  • Infection – If there are poorly fitted fixtures or improper techniques used, persistent infection can be the result.
  • Loose implants – With substandard fixtures, or if the implants are placed under load prematurely, or if they are placed in bone that isn’t solid enough, they can become loose.
  • Nerve impairment – Without the use of three-dimensional radiographic techniques, it is easy to place fixtures in positions where they impinge on nerves that run through the jaw. This can result in persistent numbness, tingling, or pain.
  • Puncture of other body cavities – We have found implants that have perforated sinuses, the mandibular lingual space, and even the nose. Needless to say, this causes discomfort and other problems.

Causes of Dental Implant Failure

Some failure happens despite the best efforts of the dentist and the patient. But some is a result of the natural tendency of both dentists and patients to look for the shortcut, the cheaper solution, the easy road. Here are some of the causes:

Shortcutting the diagnostic phase – Most dentists are trying to place dental implants with only a two-dimensional panographic x-ray. While a panographic x-ray is adequate for most dental surgery, it isn’t enough for properly placing implants. The amount and quality of bone available to support the implant, and the exact position of nerves and blood vessels that run through the bone, and the shape of nasal sinuses and other anatomic structures are three-dimensional questions. Dr. Chal believes that only carefully done CT scans, analyzed by a specialist in maxillofacial radiography, provide the level of information needed for these demanding procedures. These 3-D CT scans take less than three minutes to take, and the radiation exposure to the patient is less than 3% of the radiation received during a medical CT scan. Dr. Chal then has the computer provide printouts of one-millimeter cross-sections of the jaws showing the exact locations of blood vessels and nerves and the thickness and quality of bone.

Inadequate medical history – There are many medical conditions that affect the success of dental implant treatment. Again, thoroughness and care by the dentist here can prevent dental implant failure later.

Inadequate dental implant fixtures – There are over two hundred companies that manufacture these fixtures, but only six of them have published juried research with test results documenting the quality of those fixtures. Research is expensive, and some dentists are attracted to the companies that have cut costs and offer cheaper fixtures. The cost of a substandard fixture can be as little as one-one hundredth of the cost of a carefully manufactured, precision-engineered, and fully tested fixture, so this can be a powerful temptation for some dentists. But those shortcuts can come back to haunt the patient long after treatment is completed. The photograph above illustrates one way a cheap fixture can lead to dental implant failure. For more information, please see our page warning about cheap dental implants.

Incorrect dental implant placement - This could be tied to an inadequate diagnosis, because it’s during the diagnostic phase that the decision is made where to place the implant. It could also be a lack of communication between the restorative dentist and the surgeon. Read about one dental implant mistake of this type where Dr. Chal interceded and prevented a worse catastrophe. And you may be interested in reading about a painful and expensive case of incorrect dental implant placement that required corrective surgery.