Possible Complications of dental implants
When we talk about criteria for the success of dental implants, today we know that in expert hands the long-term success rate exceeds 95%. Logically, this success rate is achieved by correctly selecting the patient. However, a small percentage of failures does exist even when all of the protocols are rigorously followed.
These failures are not due to "rejection" since this does not exist as such when implants of proven quality are placed.
Early failures are those that occur in the first months after placement, before placing the prosthesis on them, and may be due to an inadequate bone quality or bacterial contamination. In fact, there are more failures in the upper jaw than in the lower jaw because it tends to be a more spongy bone, less compact, and ultimately of poorer quality.
Another factor that influences is the heat that can originate in the drilling prior to the placement of the dental implant, so good irrigation is essential during the drilling process, and of course, working with the appropriate revolutions of the handpieces. If overheating occurs, it can cause bone necrosis, which may cause the dental implant not to integrate. Too much pressure when drilling can also damage the bone, preventing good regeneration. Drills must be perfectly sharp and discarded regularly. Therefore, it is necessary to respect the bone biology to ensure correct healing.
Late failures such as infection can also lead to implant failure. It is essential to work with sterile material and in an aseptic environment.
If we load dental implants prematurely with the prosthesis, they can also fail. Once the prosthesis is in place, if it does not fit perfectly on the dental implants, it can create stress on them. The adjustment must be totally passive and assembled without any type of stress, otherwise failure is inevitable.
The patient’s type of bite is important, as people who clench or grind their teeth at night (bruxist) can fracture implants or cause cracks due to excess pressure.
The patient’s bit must be correctly balanced even if they do not grind their teeth, as chewing is a dynamic process and it is important to reach a balance in all of the different movements. There are types of bites that may mean dental implants are not advisable.