The chance of dental implant rejection in modern dentistry

Dental implantation is the replacement of a missing tooth with an artificial one by inserting a titanium screw into the jawbone. This is the most physiological and aesthetic way to restore the full functionality of the dentition among all the methods of dental prosthetics available today.

Modern implantation protocols make this procedure absolutely safe, predictable and most effective. However, even a flawlessly performed operation does not mean 100 successes. Although the survival rate of implants reaches 98-99%, in almost 2% of cases the titanium root is rejected.

How long does it take for an implant to take root and when can it fail?

It takes up to 6 months for the implant to take root securely in the bone. The engraftment time depends on various factors, among which the site of installation of the titanium root should be specifically highlighted:

An implant in the upper jaw takes 5-6 months to take root on average, since the bone in this area is characterized by lower density and weaker blood supply.
The osseointegration of an artificial root installed in the lower jaw takes 3-4 months.

Rejection of a titanium structure can occur either a couple of days after its installation or after several months or years. It happens that the rejection process is asymptomatic, but more often, such a complication manifests itself very clearly.

What medications can a dentist prescribe for recovery?

Recovery of the body after implantation can quite successfully proceed on its own - if, for example, an implant was placed instead of just 1 tooth or two, if the patient is in normal health and follows all the doctor’s recommendations. But often, dentists in the postoperative period prescribe medications to the patient to accelerate tissue regeneration and implant healing. The full list usually includes several different drugs, such as:

painkillers: for example, the non-steroidal anti-inflammatory drug Ketorol or the analgesic Paracetamol with a minimum number of contraindications. For severe pain, you can take 1 tablet (maximum amount - up to 3-4 tablets per day),
antibacterial agents: usually these are drugs with complex effects that neutralize various strains of pathogenic bacteria and some protozoan parasites. For example, “Cifran ST”. The dosage and number of tablets per day are prescribed by the dentist, based on the individual characteristics of the patient. The course of treatment lasts on average 7 days,
decongestants (antihistamines): allergy medications are known to relieve swelling well. Therefore, dentists prescribe, for example, Suprastin or Loratadine. The first is taken 3 times a day, and the second - once at night. The course of admission is 5-7 days,
vitamin and mineral complexes: they strengthen gums and bones, accelerating the recovery and survival of implants. Useful vitamins for gums are C and PP, and for bones - macroelements calcium and phosphorus.

Signs of dental implant failure:

Mobility of a titanium rod during immediate implantation.
Continuous postoperative bleeding (longer than 2-4 days).
Discharge of pus from the surgical wound 1-2 weeks after the intervention.
Severe pain at the implantation site, which intensifies with pressure. Painkillers don't help.
Swelling, edema, inflammation of the gum adjacent to the implant, change in its color (redness, cyanosis), proliferation of granulations, formation of ulcers or fistula.

Expert opinion

Igor Yurievich Malinovsky

Maxillofacial surgeon, implantologist

Experience: more than 11 years

Dental implant failure is a very rare occurrence. Provided that the implantation is carried out with high quality and the implants are correctly selected, everything ends successfully, and the patient uses new teeth for the rest of his life. If, due to violations of rehabilitation rules, accidental injury or other reasons, the implant is rejected, do not despair. In most cases, it is possible to install a new artificial root of larger diameter in its place after eliminating the pathological process.

Why do dental implants fail?

There are three periods of artificial root rejection:

From the moment of implantation to dentures.
Within 2 years after the intervention
In 2-3 years or more.

If the implants do not take root, the reasons for this complication are as follows:

Infectious and inflammatory process around the titanium root (peri-implantitis).
Insufficient volume or poor quality of the jawbone.
Trauma to the jaw or excessive chewing loads on the recently implanted implant, which led to its displacement and the development of inflammation.
An allergic reaction to titanium or its alloy (the material from which the artificial root is made).
Incorrectly selected implant model, errors in its design or design.
Individual characteristics of the body - exacerbation of a systemic disease, anomalies in the structure of the dental system or bone structures.
Failure to comply with the recommendations of the implantologist means lack of oral hygiene, bad habits, and dietary errors.
Errors during surgery - insufficient qualifications of the doctor, the use of implants and consumables of poor quality, non-compliance with the implantation protocol, incorrect installation of the screw structure, etc.

Regardless of what caused the signs of rejection, you should immediately consult a doctor.

Nutrition rules

The main requirement is a minimum load on the implants both on the first day and in the next 2-3 days. The following nutritional rules must be followed:

General rules for what you can eat and drink

refuse food during the first three hours,
after 3 hours you can eat: give preference to soft and warm foods (warm soups, yoghurts are ideal),
over the next three days, hot and cold food, drinks,
eliminate spicy and sour foods from your diet,
It is necessary to chew food on the side of the dentition where there are no sutures,
your diet should be varied - make sure the foods you eat contain all the essential nutrients, especially calcium,
you cannot drink alcoholic beverages or smoke,
It is not advisable to drink coffee and black tea; it is better to give preference to herbal tea or dried fruit/fruit compote,
Do not consume solid foods, excessively cold or hot drinks,
It is important to drink as much water as possible (up to 1.5-2 liters).

Don’t give up meals – gradually introduce all foods into your diet. Remember that your body needs strength and energy to recover. The diet should be of high quality and as healthy as possible.

Sample menu - what should be the diet in the first 2-3 days after surgery

soft cottage cheese, various yoghurts, you can buy baby food in jars - give preference to meat products and vegetables. In the first 2 days, if you do not receive dentures immediately, your diet will consist exclusively of liquid and puree foods,
make yourself some broth. This can also be a regular soup, but it is better to use a blender before using it. On the first day, you can afford mashed boiled vegetables. All food should be warm - neither hot nor cold,
For drinking, water is a priority, but you can indulge in warm herbal tea, especially one that acts on the nervous system as a sedative. Be sure to buy a straw - if you need stitches, you're better off eating this way.

What to do if inflammation begins under the implant?

If inflammation begins around the artificial structure, treatment consists of eliminating the cause that caused it - removing bacterial plaque, improving the quality of oral hygiene, drug therapy, including antibiotics. If the inflammatory process is localized only in the gum area and has not led to the destruction of bone tissue around the implant, there is a 100% chance of eliminating the problem and preserving the structure. With the development of peri-implantitis, severe mobility of the titanium rod or its breakage, the structure is removed and anti-inflammatory treatment is carried out.

The final decision is made by the implantologist after appropriate diagnostic measures. During the period of restorative treatment, the patient is fitted with a temporary denture, which allows maintaining the functionality and aesthetics of the dentition.

Hygiene rules

do not touch the area of sutures and installed implants with your hands or tongue,
in the first 3-4 days, limit yourself to oral baths (just hold the solution/water in the mouth), after which you can carefully rinse,
on days 3-5, that is, after the inflammation and swelling have reduced, you need to start using a toothbrush. The recommended bristle hardness is soft or ultra soft, so as not to damage the gum tissue and the area of sutures,
introduce toothpaste at the same time as starting to use the brush: Parodontax, ROCS or RasYan Herbal Clove toothpaste (for example, herbal, clove). These pastes allow effective prevention of gum inflammation,
starting from 2-3 weeks after installing the implants, after each meal, use an irrigator (to begin with, at 1-2 speed, that is, minimum), and finally rinse your mouth with water or an antibacterial rinse.

After implant treatment, be sure to buy a new toothbrush. Do not use the old one - it contains a huge number of microbes and bacteria that can lead to the development of an inflammatory process.

Is it possible to re-implant after implant failure?

In general terms, the implantologist’s action plan if a dental implant has not taken root is as follows: removal of the structure, anti-inflammatory therapy, and after 1-2 months, reimplantation with osteoplasty (if necessary).

If the cause of rejection of the artificial root is severe peri-implantitis, then after removal of the screw and complex treatment, classical two-stage implantation may not be available due to severe bone loss. Of course, it is possible to build it up, but first it will take several months for tissue rehabilitation after the elimination of inflammation, and then another 3-6 months for the engraftment of osteoplastic material and the formation of new bone.

An excellent option is immediate loading implantation. Such protocols do not require bone tissue augmentation when 3 or more implants are implanted, but osteoplasty may still be required for single restorations. If dental implants have not taken root, and for medical reasons re-implantation is impossible, there are alternative methods of restoring the dentition - removable and fixed dentures.

What you can eat and drink during the rehabilitation period, and what you can’t

In the first days after implantation, food should be soft, without hard pieces. For example, children's cottage cheese, meat in jars, as well as yogurt, broth (not fatty), boiled and pureed vegetables (you can mash with a fork or “punch” with a blender). Food should be complete, rich in vitamins and minerals - you can cook yourself an omelet with herbs, for example, or steam cutlets, cook porridge, pilaf. It is not recommended to eat very hot or cold food, so as not to burn the mucous membranes. It is better to chew on the non-operated side of the row.

Dentists recommend avoiding hard, spicy or canned foods and limiting sweets. It is also better to avoid alcohol for several reasons. Firstly, fusel oils slow down tissue regeneration. Secondly, alcohol is not compatible with drugs prescribed after implantation (in other words, there is a double load on the liver and kidneys). Thirdly, blood pressure increases, and the bleeding time from the wound may lengthen. Fourthly, there is a lack of coordination and an increase in appetite (you may accidentally damage your stitches or eat something hard).

How to protect yourself from possible problems in advance?

All the reasons for implant rejection are well known to specialists, which means that the problem can be prevented. It is for this purpose that a thorough examination of the patient is carried out, concomitant diseases and contraindications to surgery are identified.

Here are some useful tips to help minimize potential problems associated with implant failure:

You need to realize that responsibility for the results of implantation lies not only with the doctor, but also with the patient (failure to follow the specialist’s instructions can ruin the result of even a perfectly performed operation).
You should choose a clinic specializing in implantology - such centers invest enough money in modern equipment and professional training of employees.
It is worth contacting those specialists who have sufficient experience and have positive recommendations and reviews from former patients.
You need to choose high-quality implants from well-known manufacturers.
It is necessary to scrupulously follow all the implantologist’s instructions after the intervention and carefully monitor oral hygiene.
You need to monitor your health and keep chronic diseases under control (especially HIV, diabetes and other pathologies that affect the regenerative abilities of tissues).

Of course, some moments are simply impossible to predict. But we must remember that implant rejection is isolated cases, not a pattern.

Useful recommendations for patients on how to get guaranteed results

In this section, we have listed the factors that affect the quality of implant healing. Not all of them can be influenced by the patient himself. However, you need to study all the documents, ask the clinic administrator and the doctor directly all questions regarding your treatment. Even if it’s a little, it will still help you protect yourself from low-quality and unprofessional dental implantation.

The quality of the implant itself

An implant made from low-quality material and not undergone a sufficient number of clinical studies may simply not take root. Therefore, it is worth choosing products from trusted manufacturers who value their reputation and constantly test and improve their products (this can be confirmed by the long-term existence of the manufacturing company in the implantology industry, published studies on official websites). The manufacturer always provides a quality certificate, as well as a serial number registered in the common system.

Elimination of contraindications

Before dental implantation, it is important to exclude absolute contraindications for surgical intervention - the presence of malignant tumors, uncontrolled diabetes, impaired blood hemostasis, mental disorders, tuberculosis, pathologies of the cardiovascular system and the risk of developing a heart attack or cardiac arrest, problems with the immune system and the thyroid gland.

You should never agree to implantation if you are offered to do it on the very first day. You may feel healthy, but you may have a low-grade inflammatory process or an elementary viral infection that has weakened your immune system and, during the rehabilitation period, will prevent the implants from taking root well. Before implantation, it is necessary to at least undergo a computed tomography scan, blood tests, and in some cases, obtain advice from highly specialized specialists, for example, an endocrinologist, cardiologist, or otolaryngologist (ENT).

There is also a list of relative contraindications, where it will not be possible to do without thorough preparation for implantation or shifting the timing of implant installation. For example, implants can only be installed when the patient reaches 18 years of age. Women should not undergo the procedure during menstruation, pregnancy or breastfeeding. Women during menopause should also carry out the procedure with caution, because... during this period of time, metabolic processes in the body are disrupted, associated problems arise, for example, bone fragility, deterioration of metabolic processes - before implantation in this case, it is recommended to undergo an extended list of tests to identify contraindications.

There is an obvious risk that implants will not take root well even when the patient has diseased or damaged teeth. They must be treated or removed before implantation. Otherwise, they will become a breeding ground for infection and lead to the development of peri-implantitis.

Doctors also identify a so-called risk group, which includes people who have health problems or other problems (for example, smoking or a tendency to alcoholism): the presence of periodontitis or periodontal disease, ENT diseases, controlled diabetes, hepatitis, viral diseases , osteoporosis, bruxism - in patients with similar problems, as well as in older people, it is imperative to exclude even the slightest contraindications. Dental implantation cannot be performed during periods of exacerbation of any pathologies; health monitoring is also required during the rehabilitation period. Before the procedure, you need to undergo an extensive examination and visit “specialized” specialists. For patients diagnosed with diabetes mellitus and with impaired cardiac function, it is important that treatment and subsequent recovery take place under the supervision of an endocrinologist and cardiologist, respectively.

The patient's compliance with all doctor's recommendations

An experienced dentist and a well-performed implant procedure ensure a 90% success rate. Then responsibility passes directly to the patient. Therefore, both before and after the operation, it is very important to maintain oral hygiene to prevent infection of the wound with the installed implant. In addition, it is very important to take medications prescribed by a doctor and lead a calm lifestyle, excluding from it, especially at first, alcohol, smoking, physical activity, overheating, flying, visiting steam rooms and saunas. It is also important to limit the load on prostheses and implants, even if a treatment method that involves immediate prosthetics has been chosen. For example, in the first days, of course, you cannot immediately start chewing solid foods, meat, or gnawing nuts and apples.

Sterility of the oral cavity, instruments and surgical room

Sterility is the key to quality treatment (especially the operation itself). And the doctor’s task is to use only clean instruments for manipulations, so as not to introduce microbes into the implant bed. To carry out the procedure, the doctor must have disposable gloves, a mask, a special cap and gown, and the operating room must be cleaned in accordance with the requirements of SanPiN before the surgical stage. During the procedure, the specialist must remove the implant from the individual sterile packaging and, without touching areas where bacteria accumulate, place it in the prepared hole intended for installation. It is not allowed to install implants that a specialist could drop out of their hands or damage.

Correctly drawn up and developed treatment plan

How quickly and efficiently the implants take root depends on their location, as well as their size and shape, which will correspond to the individual characteristics of the maxillofacial system and the quality of the bone tissue of each individual patient. For example, if the bone is too small in height, and the implant is much longer, then, naturally, it will gradually be rejected by the body and will not be able to take root due to the discrepancy with the size of the jaw structure. And in principle, such a long implant can literally pierce other elements - the nasal sinus, various nerve endings.

It’s good if the clinic you go to has innovative computer technologies and before starting treatment, the doctor has the opportunity to work out the process in advance in three-dimensional visualization on a computer. Modern programs allow you to more accurately select the design of the implant and select the place for its implantation, create surgical templates - this additional measure is more expensive both from a time and material point of view. But it guarantees the accuracy of the operation and even provides predictable treatment results that reduce the risk of rejection of artificial structures.

Doctor's experience

The doctor must have perfect knowledge not only of the anatomy of the jaw, but also be able to apply his knowledge in practice with the help of modern computer technologies. Be sure to make sure that the specialist is certified and certified to use the implant models and methods of installation offered to you. It’s also a good idea to check information about a specialist on the Internet – both negative and positive reviews from patients spread very quickly.

How do you know if the implant will take root? Immediately after installation or after a few months (depending on the treatment protocol), the dentist will measure its stability using a special device - this is a painless procedure and very informative. The doctor determines the stability of the system by the reflected indicators, and if there are no problems, he installs a prosthesis. You can also measure stability every six months to a year after teeth restoration.

Type of selected prosthetic structure

The main requirement is lightness and weightlessness of the structures, because heavy dentures under pressure can damage and change the position of the installed implants. Lightweight structures today can be created from metal-plastic and ceramic composite. But this quality is not the only one: for the implants to take root well, it is necessary that the prosthesis be created taking into account the slightest anatomical features of the patient and be correctly fixed. So, if the prosthesis is crooked, extends beyond your bite (too high), is installed on one jaw (and the second remains toothless), then the function of chewing and uniform distribution of the load on the implants will be impaired, as a result, the bone around the artificial structures will sag, The gums will be injured and all the prerequisites will arise for the development of the inflammatory process, as well as rejection of the implants.

Use of additional treatment methods

In recent days, in conjunction with implantation, for example, PRF membranes, which are created from the patient’s blood plasma, have been used. Such membranes are enriched with platelets and the protein fibrin - they are placed in the socket along with the implant, due to which the bone is restored very quickly, and the patient’s risk of any postoperative complications is reduced. In this case, the implants will quickly take root, the bone will be restored, and you will be able to enjoy your favorite delicacies without restrictions.

What to choose: implants or crowns?

From the point of view of functionality and aesthetics of the dentition, if one or more teeth are lost, the choice between a crown and implants is clearly in favor of the latter:

An implant not only imitates a natural tooth – it completely replaces it.
The crown is placed on a pulpless and ground tooth. The tissues of such teeth become less dense and susceptible to rapid destruction, so the loss of a crown is a matter of time. The implant will last for the rest of your life.
When installing a crown, neighboring healthy teeth are injured; the implant is implanted in place of the missing unit and does not in any way affect the healthy teeth nearby.

Installation of a crown is justified only if there are contraindications to implantation.

Many patients choose traditional dentures based on financial considerations. The cost of installing a Swiss ROOTT implant on a turnkey basis is 32,000 rubles, and the price of a metal-ceramic crown is 25,000 rubles.

Questions and answers

3 years ago I had implants placed on my lower jaw and the remaining teeth were removed.
And in March, all the implants were removed. The result is changes in bone tissue and flat gums. Is it possible to install a flexible prosthesis there? I have a removable denture on top. 3 years ago I had implants placed on my lower jaw with the removal of the remaining teeth. And in March, all the implants were removed. The result is changes in bone tissue and flat gums. Is it possible to install a flexible prosthesis there? On top of my head there is a removable denture

Hello! Prosthetics with soft dentures in such cases is possible, but a preliminary examination of the oral cavity is necessary. Come visit us for a free consultation. Based on the results of the examination, our orthopedists will offer you the best options for dental prosthetics in your case. You can make an appointment by calling + 7 (495) 789-42-02. Sincerely, Patient Support Center SIMPLADENT++8 800 333-53-41

I would like to know how safe it is to carry out implantation and prosthetics at once and whether installing a prosthesis will harm the healing of the implants?

Good afternoon. I have four teeth in a row on my upper jaw on the left side that need to be removed, including two front incisors. The doctor recommends immediate implantation and prosthetics. I would like to know how safe it is and whether installing a prosthesis will harm the healing of the implants. Of course, you don’t want to walk around with a hole in your mouth, but you also don’t want to make things worse.

Hello. Modern implantation systems used in implantation protocols with the possibility of immediate dentures are equipped with special aggressive threads. Implants are screwed into the bone, providing maximum tissue compression. That is, the bone becomes stronger and firmly holds the artificial root in the hole.

The adaptation prosthesis, which is installed on implanted implants, has a metal base that works on the principle of a beam - the implants and prosthesis are a single system, which ensures high primary stability and immobility in the jaw bone. Artificial teeth fixed on a metal beam are made of metal-plastic.

This is a lightweight material that is strong enough to fully participate in the chewing process, but does not overload the implants. Only with this material is it possible to correct the bite at the time of engraftment of the implants. The prosthesis is permanently fixed and should be worn until the osseointegration process is completed - on average this takes about 6-12 months. It is then replaced with a permanent structure made from more durable and aesthetic materials. More detailed information can be obtained at a free consultation with a specialist in one of our clinics.

SIMPLADENT specialists will answer all questions by phone: + 800 333-53-41 Other questions

Factors affecting service life

Having decided to undergo implantation, you must first familiarize yourself with all the requirements for the reliability of products. The average service life of dental implants is 15 years, but when counting on installing a reliable design, you need to understand that the cost will not be cheap.

Criteria for the characteristics of implants:

strength - resistance to constant loads;
product quality;
type of production technology;
material of manufacture;
installation method.

A major role, as already mentioned, is played by the patient’s health status. Before implantation, oral approval should be performed. The presence of even minor inflammation or caries suggests a risk of implant rejection.

An important point is the professionalism of the doctor. if the structure itself is not installed securely, then most likely the pin will move or fall out.

Manufacturer and Dental Warranties

When implanting, it is better to know well-known manufacturers that have positive reviews. As a rule, you can always find information about certain implants and how long the products of a given manufacturer last. However, it is worth considering that dentistry and the manufacturer give different guarantees, since the manufacturer is based on the characteristics of the product, and the dental company takes into account the operating conditions.

Implants come in budget, medium and premium classes. Manufacturers such as AstraTech, XIVE Friadent and Nobel provide a lifetime guarantee; their products are premium and have increased strength and healing rates.

Average-priced implants have a service life (from the manufacturer) of an average of 20 years. The manufacturer's warranty for artificial roots is no more than 10 years.

Dentists, as a rule, establish a guarantee of no more than 3 years, since patients often do not follow the doctor’s recommendations for care throughout the entire period of use. The guarantee provided is confidence in the work done by the doctor.