How to Prevent Dental Implant Failure
Yuval Zubery D.M.D. | Chief Medical Officer
The majority of dental implants are successful. Anywhere between 95-98% of patients receive the full desired result with no major complications. But what about the ones that fail? What can we do to help those patients?It all comes down to performing due diligence, both with patient selection and surgical planning.
Predicting dental implant failure starts long before your patient even enters the operating room. It begins during the first consult and exam. There are several known risk factors beyond your control—bruxism, diabetes and smoking— that contribute to dental implant failure.
According to a study in the Journal of Oral Implantology, patient factors, such as the aforementioned pre-existing conditions, far outweigh implant-related factors, such as length and location, when determining the probability of a favorable surgical outcome. In this particular 10-year study, 29% of patients with a history of bruxism and 28% of patients with diabetes suffered dental implant failure. That’s a huge shift from the standard 2-5% rate in healthy patients.
Implementing a comprehensive patient screening process dramatically improves results. You need to facilitate frank discussion to get an accurate psychological and physiological profile of your patient. Disclosure of and communication regarding pre-existing dental and medical conditions are of paramount importance. If you conduct a thorough patient intake, you will learn about medical factors like depression, that may impact surgery.
The consideration of behavioral habits like smoking, which significantly increases the likelihood of dental implant failure, are critical to identify candidates primed for a positive result.
What causes the implants to fail?
Many problems can arise during the dental implant placement phase. Complications can stem from a poor patient intake process to the use of inadequate utensils to infection and everything in-between. There’s a lot of room for error, which is why you need to be hypervigilant. Below are common issues you may face:
1. Bone and tissue issues: If the size (height, width or both) of the bone doesn’t accommodate the implant, you must build more bone. This can be done either during the procedure, or as a preparatory step before implant placement. Either way, it does not pose an insurmountable challenge with proper preparation. A collagen membrane can cover the space where missing bone needs to grow. It is placed as a barrier, to isolate the area of missing bone from the soft gum tissue and allow hard bone tissue to form.
2. Inadequate dental implant fixtures: Sub-par fixtures can be problematic, but you can affect change by doing your homework. While there are hundreds of companies that manufacture fixtures, they are not all created equal. With a little digging, you can determine which companies are proactive in their commitment to research and development of optimum fixtures.
3. Infection: The risk of infection is highest in the mouth; it’s where everything you ingest enters the body. When you cut into the gum to reveal the jawbone or drill holes to anchor the dental implant, you’re opening the door to infection. Make sure you take every preventative step possible to protect your patient.
4. Sinus issues: The upper back jaw is a tricky area for dental implants due to the proximity of the sinuses. Couple that with insufficient bone quality and quantity, and it’s one tough spot. To reduce the risk of harm, sinus augmentation may be necessary to ensure a strong bone foundation.
5. Flap dehiscence: Factors that contribute to dehiscence include flap tension, continuous mechanical trauma or irritation associated with the loosening of the cover screw, incorrect incisions and formation of bone debris. To avoid wound dehiscence, tension-free closure using a buccal releasing incision is recommended.
According to the American Academy of Implant Dentistry, more than 3 million people in the U.S. have dental implants, and that number is growing by 500,000 a year. As such, the dental implant market is exploding and projected to reach $6.4 billion by 2018.
With increased dental implant demand, there are greater expectations placed on the shoulders of surgeons to deliver optimum results. To maintain and expand your patient base, you must do everything possible to improve your success rate: refine your patient intake process, properly plan for procedures and keep up-to-date on developments that improve technique. Aim to be in that 98th percentile of dental implant success…or higher. Your patients will reward you with a healthy smile.
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