Dental implantation is the most modern technology for restoring lost teeth, allowing you to successfully solve the problem of edentia (the absence of a tooth or teeth in rows). Compared to classic dental prosthetics, implantation is distinguished by greater aesthetics, durability and reliability. The operation is safe and complications are extremely rare after it is performed. However, we note that they are not always excluded, and one of the most difficult complications after dental implantation can be implant rejection.
When a dental implant is rejected in the area of its installation in the jaw bone, an active inflammatory process begins, leading to tissue destruction and loosening of the artificial root. Rejection of dental implants is a fairly rare complication after implantation, but its treatment must be started urgently!
Why does a dental implant fail, what causes the complication, is it possible to treat it? We will answer these questions in detail in this article and begin with an analysis of the factors that have the most significant impact on the survival rate of dental implants.
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Factors influencing the survival rate of dental implants
When restoring teeth using the implantation method, special dental structures are used - implants. They are implanted into the jaw bone and serve as a support for the installation of a crown or denture. The dental implant for implantation is selected individually for each patient and it is extremely important that the design has all the necessary characteristics that affect survival. Such characteristics include the type of implant coating, its shape, design features, and material of manufacture. The correct choice of dental implants significantly reduces the risk of complications, including rejection of artificial roots.
To correctly select a dental implant, the patient must undergo the most thorough diagnostics, which includes both specific measures (CT, panoramic images of the jaw) and general tests.
CT scans and panoramic photographs of the jaw enable the implantologist to see the condition of the jaw bone tissue, the features of its structure and, based on these data, choose the right implant for tooth restoration. A dental implant must not only be a reliable support for the crown - it simply must withstand regular loads corresponding to the dental unit that is being restored by its implantation. If a high load is placed on the implant, which it is not able to withstand, this may lead to its rejection immediately after implantation or after some time.
The correct choice of implantation system and thorough diagnostics are of fundamental importance for the successful implementation of dental implantation and help to minimize the risk of rejection of dental implants.
Smoking
When does dental implant failure occur
, smoking may be to blame. It itself often causes certain oral diseases, such as periodontitis. The effect of smoking on wound healing is due to the effect that nicotine and its breakdown products have on the cellular and systemic level. Smoking causes the blood vessels in the gums to narrow, reducing blood supply. Accordingly, the supply of oxygen to the wound surface is reduced and healing slows down. Nicotine prolongs the healing period and increases the risk of complications.
A dental implant does not rust, is not subject to caries, and does not rot. Despite the high quality of modern materials and the perfection of dental restoration technologies, there are categories of patients whose risk of complications is especially high. In addition to patients with AIDS and HIV, these are heavy smokers who smoke more than a pack a day, diabetics with constantly high blood sugar levels and patients with poor oral hygiene.
When pointing out doctor errors, the volume of bone tissue, its width and height deserve attention. If insufficiency of these indicators is detected, sinus lifting and bone grafting are indicated. The sterility of the instruments and the room where implantation is performed is assumed by default. Failure to comply with this rule will at least lead to infection of the hole.
How do dental implants heal?
To understand why a dental implant can fail, you need to know how the process of implantation of artificial roots occurs. In professional dentistry, it is designated by the term “osseointegration” and implies a high-quality fusion of the implanted tooth implant with the jaw bone. There are several main stages in this process.
initial stage
During this period of osseointegration, a thin layer of spongy, loose bone tissue that lacks density and strength is formed between the implant and the jaw bone. Any high loads on the dental implant during this period can lead to its destruction, slow down the healing process of the implant, and provoke its rejection. The growth of spongy tissue will occur within about a month after implantation of the artificial root into the jaw bone.
Second stage
At this stage of dental implant healing, denser and more mature bone is formed, which fills the entire space between the titanium rod and the jaw bone. The formation of mature bone takes a longer period of time - from 4 to 6 months.
Third stage
In the third stage of healing, the dental implant completely fuses with the natural jaw bone. The osseointegration process is completed approximately a year and a half after the installation of the implants, but the prosthesis can be placed on an artificial root much earlier - at the second stage, that is, six months after the operation.
The rate of healing of dental implants will be significantly influenced by the type of bone in which they are installed. Implants implanted in the upper jaw take the longest to take root because it is thinner and more fragile in structure.
Early implant failure
It can occur in the first six months, when the artificial root becomes overgrown with bone. If rejection occurs at this stage, it usually occurs without pain. The patient may feel the mobility of the titanium pin, and in rare cases, even be able to independently remove the artificial root. And you shouldn’t be afraid of this, since even a completely healthy person can experience rejection of an implant screwed in by the skillful hands of an experienced surgeon.
The cause of rejection may occur:
- from the general health of the patient;
- from his compliance with medical recommendations;
- on the volume of surgical intervention;
- on the choice of implant system;
- depends on the doctor’s ability to work with the implant system used.
For some patients (for example, with type 2 diabetes), the risk of rejection will be slightly higher, but the doctor will warn you about this in advance. But there is no need to worry here either, since even in people at risk, the implantation of artificial roots occurs successfully.
Also, the timing of osseointegration of dental implants directly depends on the following factors.
Quality and characteristics of implants. By trying to save money on implantation and choosing dubious clinics for it, you are putting your health at serious risk. If you receive a low-quality dental implant, there is a high risk of rejection and allergic reactions. Therefore, save wisely, go to a good clinic, consult with an implantologist, and the doctor will definitely offer you several options for proven implantation systems, from which you can choose the one most suitable for your budget; The implantation technique will also affect the rate of engraftment of implants. The lowest risks of implant rejection are observed when implantation is performed using classical, two-stage technology.
When performing an operation using this method, the implanted implant is immediately closed with a special plug and gum tissue until osseointegration is completed, and only then will a prosthesis be placed on it. This allows you to completely eliminate contact of the implant with the oral environment, which always contains pathogenic microflora that can provoke the onset of an inflammatory process, which can cause rejection of the dental implant.
The success, safety of dental implantation, and the speed of engraftment of dental implants also depend on the level of professionalism of the doctor who will perform the operation. If a specialist does not follow the operation protocol, ignores sanitary standards, or selects the wrong implant for tooth restoration, the consequences can be the most tragic for the patient, and the risks of implant rejection can be the highest.
Therefore, when planning dental implantation, you need to find out all the information about the clinic where you will have the operation and the specialist conducting your treatment. It would be great if the doctor not only has a diploma from a medical university, but also certificates from manufacturers of various implant systems, confirming that the implantologist really knows how to work with these brands of implants and has undergone appropriate training and practice.
In some cases, rejection of a dental implant can be caused by individual characteristics of the human body, for example, an allergy to titanium and its alloys. Titanium is recognized as a hypoallergenic material, but in some people this biocompatible material can provoke an allergy, which will ultimately lead to dental implant rejection.
Why an implant may not take root
The worst thing that frightens patients is the risk of rejection of the structure. Thanks to modern protocols and materials, the implant survival rate is as high as possible ( 97-98%
). When installing original implant systems Astra Tech, Nobel Biocare, ROOTT, Straumann, rejection rates do not exceed 0.2-0.5%, that is, the survival rate is almost one hundred percent.
When asked why dental implants do not take root, the doctor will answer after examination and diagnosis. But the patient needs to be more careful, not ignore warning signs, and immediately contact an implantologist. The success of the operation and engraftment is influenced by:
- health status;
- quality of preparation for surgery;
- choice of implants;
- implantation protocol;
- correctly calculated prosthesis design;
- careful adherence to medical recommendations in the postoperative period.
Attention to all of the above points reduces the likelihood of design rejection to zero. Typically, engraftment of a titanium root with classic two-stage implantation takes at least 3 months
. After the structure has fused with the bone, an abutment is fixed on them, and an artificial crown or prosthesis is placed on top. With express implantation or basal complex, engraftment proceeds faster. The implanted roots are loaded with a temporary prosthesis 1-3 days after surgery.
Three main reasons leading to dental implant failure
There are not many reasons why a dental implant may fail - only four. Let's look at them in detail to understand what exactly and what factors cause implant rejection.
Medical errors
We would like to draw your attention to the fact that medical errors and negligence of a specialist during an operation are one of the most common reasons leading to the rejection of dental implants. This is why it is so important to choose wisely both the clinic and the implantologist, whom you can trust to carry out such a complex operation as dental implantation and your health!
The following medical errors can lead to dental implant failure after surgery:
- Poor quality antiseptic treatment of materials, instruments, oral tissues;
- Failure to comply with developed implantation protocols;
- Errors when working with the jaw bone - excessive overheating or, conversely, insufficient cooling of the bone when forming a bed for implant installation;
- Use of low quality, outdated tools. For example, if a doctor uses blunt cutters when working with bone, tissue necrosis will occur almost immediately and then the process of rejection of the implanted implant will begin.
- Incorrect load calculation when choosing implants.
If the implant was rejected due to the doctor’s fault, the dentistry where you were treated should pay for the costs of eliminating the complication and reimplantation. However, to do this, you must have an agreement in your hands that clearly states the clinic’s warranty obligations to the patient. If the clinic, before starting treatment, does not offer you to sign an agreement that includes warranty obligations, it is better to refuse implantation in this dubious institution. Good clinics that value their reputation among patients provide services with contractual obligations of the parties to each other!
Poor diagnostics before implantation
Implant rejection can be caused by an exacerbation of some serious disease in the patient, which is an absolute contraindication to implantation.
To exclude such contraindications, the most thorough diagnosis is carried out before starting treatment, which includes taking general tests. If the clinic does not offer you to undergo a detailed examination before dental implantation, this is a serious reason to doubt that the treatment in this dentistry will be truly high-quality and safe for you. You are also obliged to inform your doctor about all the diseases you have - heart pathologies, diabetes, cancer, blood and vascular diseases. You need to tell your doctor about all the medications you have taken recently or are currently taking on a regular basis. If you don’t do this, you are putting your health at serious risk, and implant rejection may not be the only sad consequence of such irresponsibility! And it is clear that in this case there is no need to count on treatment of the consequences of implant rejection under warranty!
The patient's negligent attitude towards his health
After implantation, the doctor must advise the patient in detail on the care of teeth and oral cavity in the postoperative period.
All given recommendations must be followed thoroughly to prevent rejection of the dental implant. In addition, teeth with implants need to be cared for as carefully and regularly as natural teeth. If oral hygiene is poor, an inflammatory process may begin, which can lead to rejection of the dental implant.
Some people think that dental implant failure is something that can happen either immediately after implantation or within a short time after it. But that's not true. Implant rejection can occur 5 or 8 years after its implantation, and in this case there is only one reason for it - poor oral hygiene!
The timing of implant rejection can be a kind of indicator of the cause of the complication:
- If implant rejection occurs three to six months after its installation, then most often the cause of the complication lies in a medical error or poor quality of the implantation system;
- Implant rejection, which occurs two to three years after surgery, in most cases is explained by the wrong choice of implants or poor quality of oral hygiene;
- Implant rejection, which occurs 5-8 years after the implantation of an artificial root, as we wrote above, usually indicates that the patient was negligent about his own health and did not follow hygiene rules.
The cause of implant failure is determined during a diagnostic examination in a specialist’s office.
Primary stability
In our center, the engraftment (in scientific terms - stability) of the implant is checked using a special Osstell ISQ device a few days after the procedure. This helps eliminate the possibility of early implant rejection, and if this begins, promptly replace the artificial root.
The point of the procedure is to register resonant electromagnetic oscillations of the implant and surrounding bone when exposed to an electromagnetic field through a magnetized pin. Simply put, a signal from the device’s magnet is applied to a pin screwed to a titanium root. The implant begins to oscillate, and the force of these oscillations is taken as the implant stability coefficient (ISI). The range of KSI is from 1 to 100, and the higher the value, the better the stability of the implant. The acceptable range starts at 58 KSI units for the maxilla and 66 units for the mandible. 3-6 months after surgery, these indicators are on average 61 and 65 units, respectively.
Unfortunately, such a device is not available in all clinics where implantation is performed, and doctors often check the implant’s survival the old-fashioned way: if there are symptoms, then something is wrong. And the danger lies in the fact that if re-implantitis is not detected in the early stages, the alteration will cost both additional money and additional health.
If one of the four implants does not take root at all, then it is unscrewed and replaced with another artificial root. As a rule, this procedure is carried out at the clinic’s expense, but it is a good idea to clarify before treatment whether this is true or not.
What are the signs of implant failure and what should you do if you have these symptoms?
Dental implant rejection has its own characteristic symptoms, which include:
- Severe, persistent pain in the implant area;
- The appearance in the same area of noticeable redness of the gums, its swelling, bleeding;
- The appearance of mobility of the installed implant.
If you notice all of the listed signs, do not engage in self-diagnosis, much less self-medication, you need to urgently seek professional medical help. The longer you wait to see a doctor, the more difficult it will be to carry out treatment; in addition, if an implant is rejected at an advanced stage, severe destruction of bone tissue occurs, which will make it impossible to carry out reimplantation without first building up the bone.
Price of the procedure and other nuances
In each case, removal of a dental implant is considered in conjunction with solving related problems, an individual course of treatment is provided, so the final cost is calculated for each client. It is possible to pay for procedures in installments.
The least number of complications arise when a new tooth is implanted on the same day as the old implant is removed. There is no need to re-injure tissue or postpone the decision. Timely restoration of the row is beautiful and important. There is no additional atrophy of bones or gums, healing occurs quickly.
Experience shows: removal of implants and their replacement is a procedure that preserves the integrity of the dentition, optimal functioning of the gastrointestinal tract and increases the patient’s self-esteem during rehabilitation.
How is implant rejection treated?
Everything will depend on at what stage of implant rejection the patient consults a doctor. At the primary stage of development of the pathological process, it is possible to do without a radical method of treatment, which involves removing the installed implant. First stage implant rejection is eliminated by cleaning the tissues and all structural elements, treating them with antiseptic treatment, and the patient is prescribed antibiotics that can stop the development of the inflammatory process.
If, after diagnosing implant rejection, a decision is made to remove it, re-implantation can be carried out only after the inflammatory process has completely stopped and tissue has been restored.
What to do if the implant is mobile and does not take root
If any sign of rejection appears, you should contact the implantologist who performed the operation. Based on the diagnostic results, it will be clear whether the implant can be saved with conservative therapy or whether it will need to be removed. In most situations, after eliminating the inflammatory process and restoring the jaw tissue, re-installation of the implant is possible. In the absence of contraindications, reinstallation is carried out after 1-2 months. If the bone tissue is severely damaged due to rejection, surgery to build it up will first be required.
How to prevent implant rejection after dental implantation?
Implant rejection is a fairly rare type of complication after dental implantation. However, its risks cannot be eliminated 100%, but in order to reduce them as much as possible for yourself, you should pay close attention to the following points:
- Your preparation for dental implantation should be thorough and responsible. During the preparatory period, it is best to give up bad habits, in particular smoking, which has the most negative impact on the implantation;
- You must choose the implants for surgery wisely and thoughtfully, and remember that price is not the most important criterion! Good dental implants simply cannot cost a penny, and if you are offered products from a little-known and inexpensive brand, you are taking a serious risk! Poor quality can lead to implant rejection;
- You should refuse implantation if you have absolute contraindications to it;
- Since medical errors are the most common cause of implant failure, choose a clinic for your treatment with the utmost care. Read reviews about dentistry, check the level of equipment of the clinic, find out whether its doctors are qualified specialists and what dental implants they can work with. Remember that all this information should not just be communicated to you by representatives of the clinic, but have documentary evidence in the form of licenses and certificates;
- Follow all the doctor's recommendations that he gives you before surgery and after implantation.
Only this approach can minimize the risk of dental implant rejection!
Calculate the cost of treatment by taking a short test in 20 seconds!
Do not delay your treatment, because in this matter time plays against us.
Prevention of implant rejection
We have already written above and would like to repeat once again that rejection of dental implants can occur not only immediately after surgery, but also several years after it is performed. To prevent this, it will be useful to prevent rejection of dental implants, which implies:
- Thorough oral hygiene with properly selected instruments - brushes, brushes, irrigators, dental floss and paste;
- Regular preventive examinations at the dentist and professional oral hygiene;
- Monitoring the overall health of the body and strengthening the immune system;
- Quitting bad habits - smoking, drinking alcohol.
Prevention is the best treatment, and if you carefully monitor your health and the health of your teeth after implantation, the installed implants will serve you flawlessly for many years.
Do you have any questions about the topic of the article? Do you want to get professional advice from a dentist on the topic of dental implantation? Write to the chat on our website, call the contact numbers of our clinic, or even better - visit an appointment with implantologists at our dental clinic in Moscow - “VENSTOM”!
