Dental implants enable a permanent, firm bite and are increasingly replacing removable dentures. But how long are the implants durable? Does “once implanted, chew forever without problems” really apply to dental implants?
Dental implants risks: Peri-implantitis
Various causes can lead to inflammation of the implant bed, including if the tissue around a dental implant becomes infected.
How does peri-implantitis develop?
Dental implants are firmly anchored in the jawbone like an artificial tooth root. In contrast to your teeth, however, an implant is a foreign body. The tissue around a dental implant can become infected. At first unnoticed, it can lead to a superficial inflammation and later to a constant breakdown of the jawbone. We know this postoperative complication in professional circles as peri-implantitis.
Peri-implantitis is an inflammation of the tissue directly on the implant. The consequence of this inflammation is a breakdown of the jawbone which is often not noticed by the patient as the infectionperi- develops slowly and therefore remains painless. This infection could be noticed during x-ray controls as part of the dental examination. At an advanced stage, affected patients notice the loss of bone because of the loosening of their dental implant. Only in rare cases does this complication led to acute pain and a purulent abscess.
The consequences: bone loss because of peri-implantitis
Many aspects can promote inflammation of the dental implant and the associated bone loss.
The bone loss is promoted by:
- Bad oral hygiene
- Heavy smoking
- Periodontal disease
- Insufficient/unfavorable initial bone situation
- Incorrect or overloading of the implant
- Little tissue available around the implant
- Incorrect size of the implant
- Wrong implantation angle
- The insufficient fit of the implant-abutment (the superstructure)
- Cement residues
Which four factors favor peri-implantitis?
1. Smoking
Nicotine use encourages the development of inflammation in your implant
It causes blood vessels to constrict and thus poor blood circulation. Nicotine enters the bloodstream and inhibits cell activity for repair and renewal. Besides, it significantly reduces the immune defense in consumers, which is why periodontitis and peri-implantitis are favored. Cells and messenger substances, which break down the teeth supporting structures, are stimulated.
Acute signs of inflammation, such as pain, overheating, redness, or swelling, may be absent in smokers because of changes in the body’s blood circulation systems. The inflammation then runs predominantly in the bone in silence.
2. Your bone conditions
Implants need bones. A sufficient bone substance is necessary so that your implant can be firmly anchored in the jawbone.
Too little bone supply can lead to problems during the surgical procedure and later. Often a bone augmentation is necessary for advancement. In professional circles, we call this augmentation. Synthetically produced we introduce bone substitute materials before or during the surgical procedure, depending on the initial situation. These promote bone growth so that there is ultimately enough bone for your new implant.
Too dense bone leaves little room for the blood vessels that feed the bone. The result is reduced blood flow to the bone tissue, making it more difficult for your new implant to heal. Besides, it generates more heat when drilling the implant which also has a negative effect.
If the jawbone is too soft (e.g. osteoporosis), this is also disadvantageous. The stable healing is then at risk.
3. Pre-existing medical conditions and regular medication use
Special diseases that put a strain on the immune system and lead to a permanently weakened immune system of the body pose a risk for implantology.
These include, for example, diseases such as
- HIV
- Hepatitis
- Leukemia
- Acute tumor diseases
- Autoimmune diseases
- Diabetes mellitus
- Radiation / chemotherapy
Talk to your treating doctors and dentists if you suffer from one of these diseases. Here, implants are not always the best solution. These diseases often result in complications during implantation and represent an increased risk. However, other therapeutic approaches can usually be found for your new smile.
Taking medication
Regular use of medication also increases the risk of your implants failing. But other medications can also affect the health of your jawbone.
Risks during implant treatment
It is not only the natural conditions of your teeth that are decisive for the proper healing of a dental implant. The skill and ability of the treating dentist also contribute to successful implantation. Only implant treatment by an experienced implantologist can reduce the risk of complications to a minimum.
Even at the planning stage, it is crucial to determine the correct position for the artificial tooth root. Only a few surgeons can rely on their moral judgment for the location and angle of the drilling, thanks to their many years of experience. Besides the optimal bone supply, it is also important that neighboring structures such as teeth, nerves, and maxillary sinus remain intact. Besides, the subsequent supply of dentures depends on the correct position of the implant.
Too much pressure when inserting the dental implant can damage the structure of your bone. The damage caused by excessive pressure when drilling rarely regresses. A loosening of the implant for infections in the surrounding bone tissue is the result.
Excessive tension during the operation also endangers the structure of your bone. The jawbone gives in to the overuse and is injured.
What minimizes the risk of peri-implantitis?
If we have already placed the implant, you can reduce the risk of bacterial colonization of the implant through regular dental check-ups and appropriate oral hygiene. Once the bacteria have settled, they are difficult to remove from dental implants. Taking care of your teeth plus cleaning the implant in the morning and evening counteract such bacterial colonization.
Having professional teeth cleaning performed by your dentist’s prophylaxis assistant once or twice a year also promotes oral health. Because healthy gums create the best conditions for implant healing and thus minimize the risk of losing an implant.
Overview of protective measures:
- Have the implantation performed by an experienced specialist
- Have regular checkups at your dentist
- Take care of your teeth and your dental implant thoroughly and regularly
- Have professional teeth cleaning performed at least once a year