Dental implant problems

What are some common dental implant problems?

Dental implant problems vary from surgical to prosthetic issues and from easy to very difficult. Below is a list of various issues we have seen over the years.

Loose dental implant abutment screw

This one is a fairly easy fix unless in the front of the mouth and access to the screw is not straight forward.  The hard part is figuring out why the screw is loose.  Most often it is a lateral excessive contact.  The screw should be replaced with a new screw if this occurs.  This occurs somewhere around 0-6% Pjetursson 2014

Fractured dental implant abutment screw

Much more complicated issue.  Can sometimes be removed with a piezo.  If cold welded then that is a problem.  Here are the steps and options to fix a dental implant screw fracture.

dental implant problems

Abutment screw fracture

Fracture of dental implant abutment

Never really happened until we started using ceramic abutments or hybrid implant abutments.  What actually works is being figured out and I don’t feel is as much as a problem as was few years ago.

Fracture or chipping of dental implant crown

Fairly common and we treated the same as we treat a crown fracture on a regular tooth.  This is more common on dental implants due to lack of proprioceptive feedback.  Pjetursson 2014 found this in 3-35% @ 5 years.

Cement sepsis of dental implants

Major issue because it can cause loss of implant and is very common.  Again, this is a problem that many of “solved” through better techniques.  Not using resin cement and using custom abutments along with a duplicate of the abutment to aid in cementing should solve this problem.

Open contacts between dental implant crowns and natural teeth

A dental implant doesn’t change position in the bone but teeth do.  Thus as time goes on some people will develop an open space in-between a dental implant crown and a adjacent tooth.  It usually occurs on the mesial (front side) of the dental implant crown due to mesial drift.  It is an annoying problem but not necessarily detrimental.  We fix these problems by either intraoral repair, which is often not terribly predictable, or removing and sending it to the lab to add porcelain.  Research is showing 1/3 to 2/3 of single unit dental implant crowns develop an open interproximal contact.  Greenstein 2016 JADA

There is a really nice thread on DT that discusses this issue in depth.

Post implant placement patient growth

Placing a dental implant in an infinitival too young will definitely cause a problem as the dental implant will stay in the same place as the bone and teeth move around. It can cause some major esthetic issues. One solution is orthodontic reposition of a dental implant. The only way to move a dental implant is to move all the bone that is healed to the implant.  We can accomplish via a block corticotomy, well not us but some super-specialists.  Not an easy thing to accomplish.  This case on dentaltown shows a great result.

Craniofacial growth article discusses this phenomenon and other growth issues. A follow up interview with several other doctors discussing the issue further.

Where does bone growth occur?

This is one of those things that is easier to show than tell.

Image bone growth maxilla Image bone growth mandible Image on bone growth mandible

 

While there is certainly other dental implant problems, especially surgical dental implant problems, these are the most common.

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