Alvin H. Danenberg, DDS January 19, 2016
First, I describe the materials used for dental implants and some of the preexisting conditions in patients that could cause implant failure. Then I discuss specific situations where the actual placement of implants could cause damage in the jawbone and failure of the implants.
Materials Used for Implants
The majority of implants today are made from titanium alloy (titanium plus other elements). The new kid on the block is made from zirconia (zirconium dioxide combined with other elements). Both include metals. Both are combined with other elements to give them enhanced properties. Both allow bone to grow onto their surfaces. However, there could be rare cases of sensitivity to these metals. (There is a blood test provided by MELISA.org that can test for various metal allergies, but this test is not conclusive.)
Titanium alloy has been used in dental implants for decades and has had a long and positive track record. Zirconia dental implants have been used only for several years and have not stood the test of time.
Preexisting Conditions in Patients
While these implant materials do not cause infection by themselves, certain underlying conditions in patients could cause poor reactions in the bone and gum tissues. Some important patient risk factors include:
- Existing gum disease that was not treated before placement of the implants
- A compromised immune system that would not allow the bone to grow onto the implant surface
- A smoker whose habit contributed to poor healing potential
Situations Causing Damage Around Implants
Dental implants must be placed properly, or else they could lead to inflammation and infection in the jawbone. Three situations where improper technique could cause damage are:
- Bone could be traumatized during the placement of the implant
In order to place an implant in the jawbone, the dentist will drill a small hole in the bone in which to screw the implant. This surgical procedure is performed with sterile saline solution at very low pressure on the bone in order not to heat up the bone. If the bone becomes overheated and traumatized, bone may not grow onto the implant surface. This could result in inflammation, infection, and loss of the implant.
- Heavy biting forces could be wiggling the implant and damaging the surrounding bone
If other teeth in your mouth are touching the implant with wiggling forces or heavier forces than are normal, the implant could be wiggled in the jawbone. This wiggling motion of the implant could damage the bone surrounding the implant and create inflammation, infection, and the loss of the implant.
- Cement residue could be left under the crown, which is attached to the implant
The tooth crown may be either cemented onto the implant or screwed into the implant. If cement is used, the dentist must remove any excess cement immediately and completely. If there is any residue of cement left under the gum tissues around the implant, this could cause inflammation, infection, and the loss of the implant.
Patients must be shown the proper methods of cleaning their implants. Implants do not cause infection by themselves. Patients who have preexisting risks may not be candidates for implants. Most jawbone problems from implants are the results of dentist error.
The placement of dental implants needs to be performed by a dentist experienced with the proper procedures. Infection and eventual loss of implants could be eliminated if the dentist placing the implants (1) is aware of preexisting patient risks and selects patients accordingly, (2) is careful with the surgical technique, (3) controls the chewing pressures on the implants, and (4) makes certain that no cement is left under the crown that is attached to the implant.