Designed to enhance not just the mouth, but the overall appearance of the patient.
When you visit Boca Raton Cosmetic Dentist, your smile is our top priority. Dr. Mitchell A. Pohl and his entire team are dedicated to providing you with the personalized, quality dental care that you deserve.
Dental Implant Failure: Diagnosis and Treatments
Dental Implants have long been known to be the Gold Standard of Tooth Replacement. No other dental technology duplicates the accuracy and efficiency of an implanted tooth and the benefits derived from it. The artificial root structure is second only to Mother Nature herself.
Zirconium Abutment for Crowns
Hard and soft tissue stimulation created by the implant device preserves jaw bone mass that is critical for sustaining life in surrounding tissues. Proper placements that are free of complications can provide years and years and years of dependable service. Implants enduring for 35 years and more is not unheard of.
Early Preliminary Diagnosis
An accurate diagnosis should be obtained as soon as an implant is suspected of failure.
A restored implant may be loose, wobbly or create pain symptoms due to a failure in the restoration itself which can involve abutments, thread devices within certain types of implants, broken threads or perhaps a loosening of the abutment material (e.g., zirconium).
Repairs and replacements of these restoration failures can be completed by Dr. Pohl fairly quickly, returning the implant tooth to the normal occlusal relationship that was designed into the original treatment.
Extended delays in completing the restorative repair does pose some functional risk for adjacent tooth structures, depending on treatment history.
Implants used in bridgework that are suspected of failing will affect the entire bridge structure and should also undergo differential diagnosis asap (see picture below).
Implant Device Failure
An implant that is suspected of failing or has decidedly gone bad due to a breakdown of the osseointegration that occurs within the jawbone-implant device relationship should be differentially diagnosed as soon as possible or feasible (ASAP is better).
While root form implants are known for their healthful bone stimulating qualities….. that specific benefit exists only when osseointegration is “text book perfect”. Implant technology is unsurpassed in maintaining healthy jawbone that prevents common resorption.
A loose implant becomes an agent of failure when faulty osseointegration (i.e., osseointegration no longer exists) is known to exist. Left untreated or delayed, accelerated bone loss and jawbone damage in the immediate treatment area begins to occur.
Repairing an implant that has gone bad due to the loss of the fused state between the jawbone and implant device can involve one or more combinations of: a change in implant design, additional bone grafting, a change in type of bone graft material used (e.g., pulverized vs chin block or ramus, changing occlusal relationship (restoration height or width), etc.
Implant Failure: An Anatomy
The causes or reasons for dental implant failure are complicated and can even be confusing.
Implants that fail early, or quickly…. generally have causal factors that may be related to:
- Errors in treatment planning
- Bone graft failures
- Mis-matching of technologies to given tissue conditions or inadequate analysis of the best treatment option
Failure to use a particular implant design that produces the best predictability for success (cosmetic dentistry offers several choices whereas in implant surgery only one choice produces the best solution
This type of failure occurs shortly after the implants are placed. They can be caused by:
- poor quality of bone
- epithilial cells in osteotomy site
- insufficient bone grafting (if used)
- ineffective grafting technology choice
- contaminated implant
- contaminated osteotomy
- overheating the bone (necrosis)
- too much force when they are placed
- not enough force when they are placed
- excessive forces during osseointegration (chewing, biting)
- a myriad of other reasons
Implants that become wobbly, loose or fall out after a significant period of optimal function typically result from excessive forces on the implant… which most commonly arises out of a shifting bite or changes in the vertical dimension (normal height of upper and lower jaws in the resting position).
Adjacent, normal teeth wear differently from a porcelain restoration. A perfectly placed and functional implant can fail in the future if the the occlusal relationship between the implant tooth and natural teeth is not monitored (routine checkups should never be minimized). Teeth clenching, in particular, should be monitored on a routine basis.
If a bite – occlusal relationship should change, it is possible that opposing biting forces can become redistributed to the extent they create a lateral force that exerts pressure horizontally, something a dental implant is not designed to withstand.
Implant Supported Bridgework
Implants used in bridgework offer excellent choices in multiple tooth replacements that are affordable and provide attractive dental cosmetics.
Maintaining good oral health with bridgework does require the practice of routine hygiene habits.
While anchor teeth that are implant supported are superior to cemented bridgework (bridge is mounted on natural anchor teeth), poor habits can lead to an accumulation of bacteria and eventual infection.
Discolorations, seepage of bacterial contaminants and occlusal damage can occur with one tooth or even all of the teeth in a bridge. Early diagnosis and timely treatment of a failed implant anchor can prevent this type of damage.
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