Management of Failing Implants
Dental implant have success rates of 90-95% at 15 years.
However, this also means that 5-10% of implants can have problems over time.
This is associated in patients with high risk of the following conditions
Poor medical health
Previous/active gum disease
Poor planning and placement of implants where the restorations are not cleansable
Heavy biting forces/grinding on implants
Peri-implantitis is an issue which is becoming more common, simply because we see more and more patients who have been treated with dental implants over the years. vIn many respects there are similarities with periodontal (gum) disease around teeth.
The first sign of a problem may be soreness or bleeding from the gum – ‘mucositis’. Treatment at this stage may prevent progression to peri-implantitis, when progressive bone loss starts to become an issue, and can ultimately lead to catastrophic loss of the supporting bone as well as the implant or implants.
In our practice we only use the highest quality of implants and titanium or zirconium abutment connectors to connect the implant tooth to the implant 'screw'. These are exceptionally biocompatible materials, which tend to maximise gum health. Unfortunately we see many patients every year who have been provided with low-cost treatments that have used low-cost implant components and laboratory work.
Peri-implantitis can take years to develop, progresses slowly and the fact that inappropriate materials or techniques have been used may only become evident later on. When there is substantial bone loss, this will usually lead to complete failure of the implants and restoration, making re-treatment more complicated.
We treat many patients every year who have been referred to us, with bone loss caused by implant treatments who have not been able to find treatment elsewhere.
Treating peri-implantitis can be extremely challenging. We know that meticulous hygiene will improve comfort and slow down the progression of the condition.
Treatment consists of cleaning under the gum of the implant meticulously using ultrasonics and jet-polishing and grafting with bone scaffold materials in order to replace the missing bone tissue or thicken the surrounding gum. This sort of treatment can make the area more comfortable and the peri-implant condition more quiescent, allowing for survival of the implant crown or bridgework.
Where the problem is persistent or there has been advanced bone loss, there is sometimes little alternative but to remove and replace an ailing implant, which may also mean loss of the implant restoration.