Dental implant surgery is often a highly effective, successful surgery, but it is not appropriate for everyone, and, for some patients, it can also lead to long-term complications. Dental implants are used to replace missing teeth and are intended as a permanent replacement. Dental implants are made up of separate parts: the fixture; the abutment; and the prosthesis. The fixture is the part of the implant that is surgically implanted into the jawbone and serves as the replacement tooth root; once the fixture has healed and fused with the bones in the jaw, the abutment and prosthesis are affixed to the implant, and the replacement tooth or row of teeth is complete. Dental implants have become a widely preferred and popular way to replace one or more missing teeth, with nearly 3 million people in the US alone having undergone dental implant surgery.
Some complications with dental implants can arise following dental implant surgery. It is imperative that patients follow their surgeon’s advice for proper aftercare, as infection may arise otherwise. Infection following implant surgery may be treated with antibiotics or a soft tissue graft, depending on the location and severity of the infection. If infection progresses into the bone, this may necessitate the removal of the implant and infected bone tissue, followed by a graft of both bone and soft tissue. Though it is not due to infection, if the gum tissue surrounding an implant begins to recede, painful inflammation can arise. When this happens, timely treatment from a dentist may be the only way to maintain the implant.
As soon as the dental implant fixture is placed, the jawbone surrounding the implant will begin to heal around the fixture. As it continues to heal, the fixture will gradually heal into the bone, in a process called osseointegration. Osseointegration usually takes a few months, and it is vital to the implant’s success, as it allows the fixture to provide a solid, stable platform for the permanent dental prosthesis. If osseointegration fails to occur, the implant must be removed and a new implant can’t be placed until the surgery site has fully healed.
If, during the surgical process, the implant fixture is placed too near a nerve, this can lead to long-term pain, numbness, or tingling at the site of the implant. Any nerve damage requires prompt professional attention. Especially when in the lower jaw, nerve injury can lead to persistent numbness in the surrounding lip and chin, continued pain, and possibly to a tickling or burning feeling in the gums and skin.
Dental implant surgery may also lead to issues with the sinuses, such as sinusitis, if the implants project into the sinus cavities. Sinusitis can lead to swelling or tenderness around the eyes, forehead, or cheeks; a reduced sense of smell; a feeling of blockage in the nose; darkened or tinted mucus in the nose; headaches or toothaches; foul breath; or a feverish temperature.
Excessive force may also damage a dental implant, just as it might with a natural tooth. Force may damage or loosen a dental implant and can be caused by grinding of the teeth or other involuntary habits or behaviors. If you have a dental implant and are known to engage in bruxism, or grinding of the teeth, you may need to wear a mouth guard to protect the implant, especially while sleeping.
While none of these problems are common, more rare issues include peri-implantitis or rejection of the implant. Peri-implantitis, which develops because of chronic inflammation at the implant site, can lead to bone loss at the implant site and usually takes about 5 years to become symptomatic. Symptoms include swelling and bleeding at the implant site. Implants may be rejected, depending on the material they are made of, if the patient has a sensitivity to certain metal materials; for this reason, it is recommended that patients undergo sensitivity testing for metals before receiving metal implants.
For people who are in general good health, with healthy gum tissue and a sound jawbone, dental implants can be an excellent long-term way to replace one or more missing teeth. Because their facial bones are still growing, children are not good candidates for dental implants. Other possible risk factors for dental implant failure include diabetes, gum disease, smoking, radiation therapy, and certain medications. If you are a good candidate for dental implants, be sure to provide a complete and thorough medical history to your dentist, and, to facilitate healing and future implant success, carefully follow all aftercare instructions after dental implant surgery.