One of the common questions Dr. Rob Wolanski hears from patients is “do implants ever fail?”
“The short answer is yes,” says Dr. Wolanski, from Nanaimo’s Lakeside Dental Clinic and the Vancouver Island Implant Centre. “Dental implants are in essence a foreign body and can be rejected for a number of reasons. The four most common are improper placement, too much bacteria – such as not been cleaned well – too much bite force, and a change in the patient’s overall health.”
It’s uncommon for implants to be working well and then simply become loose. Typically someone will experience a period of inflammation and bone loss prior to the actual loss of the implant.
“We call this period an ailing implant and it’s important that it be recognized and treated early,” Dr. Wolanski notes. “If identified early by regular examinations, an ailing implant can often be treated to prevent its loss.”
Proper placement & care are key
Numerous parameters dictate the optimum placement of a dental implant, including not overheating of the bone when drilling, not hitting vital structures when placing the implant, and ensuring the implant is completely submerged into the bone and covered by an adequate thickness of bone. With the use of three dimensional CT scans, the optimal placement is much more predictable today.
As far as too much bacteria, this is related mostly to the patient’s ability to keep the implants clean. “This is optimized by the design of the prosthetic teeth that sit on top of the implants,” Dr. Wolanski says. “Some patients are also less resistant to bacterial attack. We see this in people with natural teeth as well. For instance some people are much more susceptible to gum disease than others and can lose their teeth as a result.”
Too much bite force can simply overload the bone supporting the dental implant. When this happens the bone starts to shrink away from the top part of the implant and exposes the rough threads, which allows bacteria to start to infect the implant. It’s important that the bite forces be analyzed and considered when planning a case. “The bite forces can be dealt with by using implants with a greater surface area to distribute the load as well as a greater number of dental implants,” Dr. Wolanski notes. “As well, the prosthetic design of the teeth can spread the load more evenly. This is something that comes with many years of experience placing dental implants.”
Finally a change in the patient’s overall health can affect the longevity of dental implants. For example, a patient that acquires hepatitis C or uncontrolled diabetes can exhibit bone loss around the dental implant which can lead to its ultimate loss.
“Although it is true that dental implants can fail, our success is very high, ranging from 90 to 98 per cent, depending on the patient and the area the dental implants are placed. The procedures have become more predictable over the last 27 years I’ve been placing dental implants and we’re grateful for the many patients we have treated and help change their lives.”