What problems can arise during dental implantation and how to avoid them

At Sirius Dent Medical Center, dental implants are almost always successful. Even if the implant does not take root on the first attempt (this happens in less than 1% of cases), the second one will certainly be successful.

What is a «failed dental implant»?

An implant is considered unsuccessful when the implant cannot be used as a support for the crown. That is, it has disintegrated or is incorrectly positioned (it is not located in the body of the jaw bone, but extends beyond its boundaries and damages other structures).

On the upper jaw, an incorrectly positioned implant can enter the nasal cavity, in the projections of the lateral teeth – into the maxillary sinuses, or pierce the cortical bone and come out into the submucosal layer. As for the lower jaw, this primarily concerns damage to the neurovascular bundle passing through its body. If an intraosseous hematoma forms during the operation, it will press on the bundle, and this will cause temporary paresthesia (numbness) of the corresponding side of the face. If the implant damages the bundle, this paresthesia will remain forever. As in the upper jaw, there is a possibility that the implant will pierce the bone and enter the submucosa. If the implant is installed with an included defect, if positioned incorrectly, it can damage the roots of the teeth nearby.

If drilled incorrectly, a thermal burn of the bone is possible, and it will necrotize. The implant will not have a chance to take root. But modern equipment does not allow such a mistake to be made.

According to the rules, the implant must be installed in the bone with a force of 30-35 N cm, and the diameter of the bed must correspond to the selected model – if these parameters are not met, the implant will be rejected.

A large number of various complications arise when the implant is installed in difficult anatomical conditions: for example, immediately in the socket of an extracted tooth or after bone plastic surgery.

Why is it important to perform bone augmentation?

Without a sufficient amount of bone tissue (minimum 8×4 mm), implantation is impossible. The implant must be located inside the jaw, and if there is not enough space, it will damage nearby structures with fatal consequences for the patient. For example, on the upper jaw, it can pierce the maxillary sinus, causing odontogenic sinusitis, or in the worst case, fall inside. Some manufacturers produce non-standard types of implants for patients with a lack of bone tissue, but the probability of their successful engraftment is much lower, so we at the Sirius Dent Medical Center use exclusively classic intraosseous implants.

If the dentist sees that there is not enough bone tissue (it can be lost during tooth extraction, due to inflammatory processes or atrophy over time), then before implantation it is necessary to perform bone grafting to restore the required volume. In the upper jaw, this is most often a sinus lift, and in the lower jaw, alveolar ridge splitting. There are other options, such as bone grafting.

Usually, after bone grafting, a person has to wait another nine months for implantation, until a sufficient amount of bone has grown. But at the Sirius Dent Medical Center, we save our patients’ time and combine the two stages of tooth implantation into one operation, that is, the implant is installed immediately after the sinus lift, and new bone tissue is already formed around it.

What will happen if the gums are not formed correctly?

Sufficient jaw bone volume is not everything. After all, it is important for a person that the implant looks like a real tooth that has erupted. If we see that the mucous membrane looks unnatural, this indicates that the tooth is lifeless. Just as in a successful landscape, an object does not simply exist by itself, but is skillfully inscribed in the environment, the dentist takes care of the «red-and-white aesthetics», that is, he tries to organically «inscribe» the crown into the dentition. This is precisely the purpose of the gum former, which is installed on the implant.

hy may an implant fail to take root?

The truth about dental implantation is that 90% of complications are the result of improper planning. At Sirius Dent Medical Center, we take the preparation as carefully as possible and take into account all possible problems. A dental implant may fail to take root in the following cases:

• insufficient bone volume;
• incorrect positioning;
• violation of the drilling protocol;
• insufficient primary stabilization;
• implantation in the presence of contraindications (for example, an inflammatory process in the bone).

Another 9% of failures are due to insufficient qualifications of the doctor, and occasionally disintegration occurs due to the patient’s behavior. For example, when implantation is performed under local anesthesia, the patient may involuntarily move his head. This is why at Sirius Dent Medical Center, dental implantation is usually performed under medical sleep, without stress and pain for the patient.

Can dental implant rejection be stopped

Successful osseointegration requires that bone tissue grows around the implant. If epithelial tissue grows instead, the implant will not hold in place and will be mobile, and therefore is not suitable for further dental prosthetics. Even if it does not fall out, but remains in the bone, it is impossible to stop or reverse the process of implant rejection. The only thing left to do is remove the implant, wait for more favorable anatomical conditions, and install another one of a larger diameter.

Why might a crown be loose?

In order for the crown to look like a tooth that has erupted, it must extend 0.3 mm below the gum line. If this condition is not met, the red-white aesthetics suffer and the tooth looks artificial.

With an implant, the situation is slightly different, because the crown rests on the abutment, which can be located a little higher. From a functional point of view, there is no problem here, but for the tooth to look natural, it is desirable that the abutment ledge is 0.3 mm below the gum line.

What other problems can arise during dental implantation

In dental implantation, an important role is played by the individual anatomical features of a person, for example, the presence of concomitant pathologies or dense bone tissue. In the latter case, the patient will have pain for several days, from which we prescribe painkillers. A number of complications may be associated with unfavorable anatomical conditions: inflammatory processes in the oral cavity or implantation after the extraction of a tooth with a cyst. It is these factors that will determine the consequences of dental implantation. Therefore, the next day after the operation, the administrator calls the patient and asks in detail about his condition, and if he is worried about something, he invites him to a follow-up visit.

How can a patient understand if everything is okay?

If after dental implantation the patient feels good, nothing bothers him, and the wound does not hurt, he can calmly wait for prosthetics (six months on the upper jaw and three months on the lower). After installing the crown on the implant, a person should be able to chew normally without pain.

What to do in case of problems during the implantation process

If any complaints appear after implantation (swelling, pain, fever, suppuration), you should contact the implantologist and come for an unscheduled examination. Under normal conditions, control examinations are carried out on the fifth, seventh and ninth days.

How to avoid possible problems during dental implantation

Problems during dental implantation are caused by the actions or inaction of the doctor, so the patient has no influence on the situation. The only thing he can do is to choose the right specialist before starting tooth restoration. Sirius Dent Medical Center has over 20 years of experience in successful implantations and works only with the best global manufacturers. We have all the necessary technical equipment to ensure the operation is safe, pain-free and stress-free.