Periodontal disease and dental implant failure
One of the concerns with anyone that has dental implants is, how successful will they be? This is clearly a question which needs answering, working on the assumption that a dental implant has been placed into a sufficient amount of bone then the biggest reason that an implant files is lack of post-placement care.
A dental implant integrates entirely with the body and needs to be looked after much the same as a natural tooth.
How do dental implants fail
Typical reasons for failure of dental implants include:
- Poor surgical decisions. This can involve placement of implants in insufficient quality or quantity of bone & poor design of the final restoration.
- Abusing your oral environment. Studies show that smoking can inhibit healing, smoking restricts blood vessels which can mean that the implant placement doesn’t heal as well. Alcohol has also been shown to increase risk of post operative complications, including general infections and wound complications.
- Dental decay. If you already have tooth decay on other teeth when you may be more susceptible to developing gingivitis and/or periodontitis around the implant area.
- Overloading the dental implant. If you have a poor/heavy bite and/or grind heavily you may overload the dental implant and support structures. Extreme contact sports can also affect the success rate.
- Overall poor oral hygiene. Implant failure is also exacerbated by bad oral health, implants succeed much better in a healthy environment.
Risk factors of periodontal disease and peri-implantitis
Risk factors for periodontal disease include:
- Age – Indicators are that 70% of people over the age of 65 have periodontitis.
- Smoking – Smoking affects your body’s ability to heal and alter is the bacteria levels in your mouth.
- Genetics – Some people are just more prone to developing periodontal disease and peri-implantitis
- Stress – Stress can lead to a general reduction in overall body health meaning your ability to heal is reduced. Stress can also mean you grind your teeth more.
- Bruxism – Teeth grinding
- Poor diet – A poor diet can also affect your body’s ability to heal itself leaving you more inclined to gum disease which then leads onto periodontal disease
The early warning signs
One of the earliest warning signs of periodontal or periimplant disease is gum disease or gingivitis. Periodontal and periimplant disease are the progression of gum disease which hasn’t been treated. Gum disease is an infection of the gum whereas periodontal or periimplant disease are an infection of the surrounding support structures around either the tooth or the implant.
Therefore the early warning signs include:
- Puffy or red gums around the tooth or implant
- Bleeding upon mild brushing around the gum or implant
- Persistent bad breath.
- Gums that are receding making the teeth look along.
Whether the signs appear around a natural tooth dental implant it’s important that the early warning signs are treated. If you end up with periodontal disease you can end up with tooth loss… Tooth replacement can then be quite expensive! The same can be said if you have gum disease around a dental implant, ultimately this could lead to failure of the implant and bone loss.
If the dental implants fails is it worth getting another?
Complete failure and loss of the dental implant happens in less than 3% of cases so it is fortunately quite rare. You should always have a discussion with your dentist about the reason the implant failed, if the reason can be clearly identified and resolved i.e. smoking, poor oral hygiene, teeth grinding etc then yes, it is probably worth having another dental implant.
If the reason for the implant failure persists then it may be wise to look for alternative ways to replace the missing tooth/teeth.
Is it possible to completely cure peri-implantitis?
Research published in 1994 using techniques modified from the periodontal arena have shown that the best way to treat peri-implant problems is to
“…arrest the progression of disease and to achieve a maintainable site for the patient’s implant”
The study goes on to say that
“Bone regeneration is possible in selected peri-implant bony defects when appropriate surgical techniques are used, implant surface preparation is achieved, and the cause is eradicated.”
It therefore is possible to treat periodontal disease and dental implant failure with skilful dental and surgical techniques.