What are the key local and surgical factors related to implant failure
Mohanad Al-Sabbagh, DDS, MS, Ishita Bhavsar, BDS
- Dental implants are now the preferred line of treatment for the replacement of missing teeth. Additionally, implant-supported full-mouth prostheses are a good treatment option for patients who are completely edentulous, achieving a comprehensive and functional oral rehabilitation.2
- Although endosseous implants have a predictable outcome and long-term success, they sometimes fail. 3, 4
- Implant failures are categorized as primary (early), when the body is unable to establish osseointegration, or secondary (late), when the body is unable to maintain the achieved osseointegration and a breakdown process results.5
- Implant failures also are classified on the basis of the time of prosthesis placement; in this classification, early implant failure usually occurs before the prosthesis is placed, and late implant failure is associated with functional loading after the placement of the prosthesis.
- The process of osseointegration between the host’s bone tissue and the implant is the key to the success of the implant.
- Some of the most common causes of implant failure at an early stage are surgical trauma (overheating, inexperienced surgeon), bacterial contamination (failure to maintain aseptic conditions during implant placement, poor oral hygiene status), delayed wound healing (host-related), and early loading of the implants.
- Implant failure is twice as common among completely edentulous patients as among partially edentulous patients. Both early and late implant failures appear to occur approximately 3 times more frequently in the maxilla than in the mandible.11
Purpose of the Article
The article summarizes our current understanding of the local factors that can be linked to implant failure.
- Clinicians should critically evaluate the patient’s oral hygiene, compliance, motivation, and risk factors before suggesting dental implant treatment.
- Achieving primary stability is important for successful implant placement.
- Host-related factors, operative-related factors, and implant-related factors may influence the outcome of implant treatment and should be thoroughly evaluated during treatment planning.
- Practitioners treating patients with systemic metabolic disorders, such as diabetes or osteoporosis, those undergoing radiation therapy, and those who smoke, should follow a 2-staged approach for optimal implant outcome.