Fortunately, it is very rare for dental implants to loosen or fall out, because after ten years, according to current statistics, 95-98% of the implants are still firmly anchored in the bone. But when a dental implant actually wobbles, it is first of all a shock! You have invested a lot of time and money in the treatment. But how can this happen and what consequences can you expect if this happens?
What does a loose implant mean?
It doesn't always have to be the whole implant that wobbles. In the majority of cases, a dental implant consists of three parts: the implant body, a spacer sleeve and the new tooth crown. The spacer sleeve shapes the gums and is the connecting piece between the implant, which sits in the bone, and the visible tooth crown. It is fixed in the implant with a screw.
If an implant has already been completely restored with a new tooth, it may also be possible that only the tooth crown or the spacer sleeve is movable. So the implant only appears to wobble. If you have any signs of loosening on your implant, it is important to talk to your dentist right away!
What can I do now?
If you sense your implant is loosening, or if it falls out, see an experienced implantologist as soon as possible. He or she can use a clinical examination or an X-ray image to determine which part is moving or loose. If only the spacer screw has loosened, it can be reattached and you can go home with peace of mind. We recommend replacing the spacer screw and tightening it firmly.
How common is such loosening of the spacer screw?
The screw seldom loosens. It should be used professionally with a dental ratchet and the specified torque. The spacer sleeve and spacer screw should be original products from the manufacturer of your implants. In this way, the products are optimally coordinated with one another. But beware! If the spacer sleeve loosens several times, it can be a sign that the crown is being improperly stressed. Then the implant should possibly be restored to prevent damage to the implant and the surrounding gums.
What to do if the implant itself is loose?
If, in exceptional cases, the specialist dentist finds that the tooth crown and implant are loose, they should unfortunately be removed.
The implant grows into the bone. If the bond between implant and bone is lost, there is only a connective tissue cuff around the implant. This cuff can no longer ossify. The implant should now be removed as soon as possible, as the surrounding bone continues to degrade if the implant body wobbles.
An implant usually loosens in the first three months, in the so-called "healing phase". This damages the implant bed so that it loses its stability. The cause can be inflammation. Or the implant has already been inserted unstably. Incorrect loading or excessive stability with compression of the bone tissue can also be reasons. Furthermore, general medical causes can also lead to a relaxation, such as a reduced immune defense.
In all cases, however, the implant should be removed immediately. Sometimes a new implant can be placed immediately. The prerequisite for this is that there are no signs of inflammation around the connective tissue after the implant has been removed. If this is the case, implantation is only recommended after two to three months, i.e. after the inflammation has subsided.
The implant can be removed under local anesthesia, or under sedation for anxious patients. It is a minor surgical procedure that is usually completely painless.
How can I prevent the implants from loosening again?
When treated by specialist dentists or experienced implantologists, it is usually a one-off event due to local factors in the area of the implant bed.
With a detailed implant planning on the computer based on a three-dimensional x-ray, the bone volume can be assessed before the implantation. The implants are then inserted through precision templates. This can reduce the risk of complications.
In rare cases, general illnesses or the use of medication can influence the success of the implantation. For this reason, it is important that you inform your implantologist about your medication intake.
As a patient, how can I contribute to the success of the treatment?
Make sure you have good oral hygiene and stable mucous membrane conditions. If you have periodontal disease, you should start treatment before any implants are placed.
In addition, regular implant checks are advisable. If you notice the first signs of loosening, you should contact your implantologist immediately.
The most serious cause of dental implants falling out: peri-implantitis
The most common cause of early implant loss is peri-implantitis and is a serious complication. This disease can be an early complication- happening right after an implant is placed- or a late complication, because the inflammation can either develop before the bone has healed from the implant or much later after you have healed from the surgery.
If the tissue around the implant becomes inflamed in the weeks after implantation, healing often does not take place at all. The implant cannot bond with the bone; and it is lost. As a late complication, peri-implantitis can occur after healing, and it can even take years before inflammation develops.
Due to the inconspicuous course of the disease, it often goes undetected. Symptoms such as dark red gums that bleed when touched or spontaneous evacuation of pus do not appear until the inflammation is advanced. In early stages of the disease, pain is rare.
What is peri-implantitis?
Peri-implantitis describes inflammation of the tissue around a dental implant. The inflammation is caused by the adhesion of harmful bacteria (in the form of plaque) to the surface of the implant. The tissue reacts to these bacteria with an inflammatory reaction that can destroy not only the soft tissue but also the surrounding bone. As a result of bone loss, the implant loses its hold in the bone, it becomes loose and can fall out.
If you think you might be experiencing symptoms of peri-implantitis, contact your dentist immediately. Symptoms include:
- Dark red gums, dark discoloration (healthy gums are pale pink)
- Gums are swollen, not clinging tightly, and bleeding to the touch
- Probing / touching hurts
- Probing / touching leads to secretion and / or pus evacuation
- Increased depth of gingival pockets (probing depths)
- After severe bone loss, the implant turns are exposed (visible)