Dental implant failure

dental implant failure due to anterior cantilever

Common reasons for dental implant failure

Dental implant failures can broadly be put into 3 categories; poor planning or execution by the doctor, mechanical failure, and host failure. Often there is a mixture of these reasons.

Poor planning or execution by the doctor is the number one reason for a short term failure.

Although we are calling this a doctor failure the truth of the matter is we usually know who is at higher risk for having the dental implant not take due to patient factors. If you do not have very good bone or have enough bone, there are definitely going to be higher chances of the implant failing. There are several sub-categories under this section.

Not enough bone for a dental implant

This is often a short term failure as the implant never heals and is lost in short order. This is something surgeons are often dealing with. The decision has to be made on whether to make the patient go through a timely and costly bone grafting procedure or to run the risks of the implant failure. Sometimes we push the limit just a little too far. The result is the implant never takes.

Poor placement of the implant

The poor placement of a dental implant can lead to failure in the short or long term. The worst case is an implant that fails shortly after a new crown is made. That is bad news for everyone. Typically we see this in the anterior where a dental implant is too far forward. There are exceptions as sometimes the individual has incredible adaptive abilities.

Poor design of the prosthesis

There are plenty of ways to screw up an implant the is perfectly fine by restoring improperly. Probably the most common is to place too much force on the implant too early, for instance by leaving the bite high. Another way is by restoring the implant with a significant cantilever force.

Dental implant failure due to cantilever
This dental implant failure, like many, is multi-factorial. The position is not ideal resulting in the anterior cantilever. The patient is also a heavy anterior grinder and worn down the natural teeth to the point only the implant crown was in occlusion in protrusive. So it’s part poor position, part poor prosthesis and part patient factors.

Mechanical failure of dental implant can occur

Mechanical failures can happen. Typically, they occur when certain types of implants, like mini implants or an implant with thin metal areas at the coronal. Mini implants can break in the middle, which is a real mess. When the rim of a dental implant breaks we call it flowering. Both of these can sometimes, to some extent be under the poor planning category but not always. Basically it should not come as a surprise that everything can and does break at some point.

X-ray of a dental implant failure due to breaking

The final reason for dental implant failure is host failure.

A host failure can come in the healing phase when the body rejects the dental implant or later known as peri-implantitis. Many health conditions and medications can interfere with bone healing and result in dental implant failure. The most common health condition to cause failure is diabetes. There are many medications that cause result in failure; immunosuppressive medications, SSRIs, proton pump inhibitors, and bone strengthening drugs.

Another failure method that is patient specific is patients that grind or patients that simply to not take the time to clean or maintain their dental implant.