Common Dental Implant Complications
Toxic Dental Implants
Non-FDA-approved dental implants are toxic to the bone. The dental radiograph above on the right shows a suspicious halo.
The 3-D CAT scan below shows a large dark halo that confirms that no bone will attach (integrate) to this toxic surface. The tissue and bone around these implants become inflamed and infected. They will either fall out or require surgical removal.
Implants Not in Bone
This patient was expecting an implant-supported, palate-less upper denture and an implant-assisted lower denture from her dentist. Being disappointed with the care she was receiving, she came to Dr. Arthur Chal for a second opinion.
The x-ray on the right, a traditional frontal view, seems to show that all the implants are in solid bone.
Our skilled dentist, however, always uses 3-dimensional CAT scans to evaluate dental implant placement and patient treatment options. In the cross-sectional view in the CAT scan, however, it can be seen that there is actually no bone support for the implants.
Here are cross-sectional CAT scans of two of the upper implants. The red arrows indicate the white cortical bone. Notice where the bone ends, and that there is no bone on the front of the implants. These implants were never placed correctly. Sadly, they will need to be removed, bone- and tissue-grafting will have to be done, and new implants will have to be placed following correct case planning principles.
This patient came to Dr. Chal after her dentist had placed implant root forms and crowns on her lower right, replacing her first and second molars. The second molar implant was already loose in its socket, and there was bleeding around the first molar implant.
The cross-sectional CT scans on the right show what is happening here. On the second molar, the dark halo shows that there was never any bone integration, which is why it is loose. On the first molar, the placement of the implant missed the bone.
Both implants are also too short. The red arrow on the first molar view shows the location of the nerve canal. There is ample bone for the placement of a much longer implant and an adequate safety zone. Compare the lengths of the implants to the adjacent natural tooth.
Both of these implants will need to be removed and replaced with longer root forms, and with more careful placement.
Inadequate Diagnosis and Treatment Planning
Here is a case of a lovely young woman who presented at Dr. Chal’s office with a loose implant-supported front tooth. The CAT scan images clearly show a lack of supporting bone present. There simply isn’t enough bone here to support an implant. With proper diagnosis and treatment planning, the treating dentist would have given the patient two choices: either bone grafting to build up the implant site, or replace the missing tooth with a bridge.
To compound the error, the dentist created an excessive angle between the crown and the implant fixture. The maximum angle allowed is 15º. The angle created by this dentist, as is marked by the green arrows above, is 45º.
The resulting stresses on this implant have caused destruction of the bone around the implant, as you can see in the bottom radiograph (frontal view). The orange arrows show the darker areas around the implant which represent bone loss on the sides of the implant.
Sadly, the only remedy for this case is to remove the implant and start over.
Poor Surgical Technique
In the age of contemporary implant dentistry, when multiple teeth are extracted, techniques are available to preserve the bone so that it can support future dental implants.
In this particular case, the patient presented to Dr. Chal with immediate dentures had been placed two years ago, but she had never been comfortable. Wearing the dentures was painful. At this point, since no bone preservation techniques were used by her previous dentist, complicated bone and tissue grafting would be required to provide implant-supported restorations.
The red arrows show the position of the nerve canal in both frontal and cross-sectional views. In effect, this patient was wearing her denture right on top of the nerve, which would naturally be painful.
Short Dental Implants
Click here to read a case study of a patient with short Bicon dental implants.
Improper Dental Implant Placement
Click here to read another case study showing nerve inflammation from improper dental implant placement.