Implant Complications: What is the Scope of the Problem?

This summary is based on information found in Dental Implant Complications: Etiology, Prevention, and Treatment, 2nd Edition (Wiley Publishing, 2015)

• The introduction of endosseous dental implants as an option for restoring partially and fully edentulous patients has revolutionized dental treatment.
• High survival rates reported for single and multiple missing tooth replacements have validated the use of implant-supported restorations as a predictable method for oral rehabilitation (1–9).
• Problems with implant complications have grown in number and complexity and that is reflected in the increased number of articles, journals, and continuing education conferences that have recently been devoted to the topic of implant complications (12–31).

Reasons for the increased numbers of implant complications

• The total number of implants being placed has increased significantly over the past 10–15 years.
• The increased number of implants being placed reflects an increased number of dentists, varying in their clinical experience, placing and restoring implants.
• Until recently, there were few formal training courses in implant placement or restoration for dental students during their 4-year dental education (32) with the majority being didactic in nature and not including clinical experience with implant placement and restoration.
• Dentists are placing implants in compromised sites using more aggressive protocols.
• Lectures and courses that dentists attend and which frequently cite the high implant success rates reported in the literature despite a number of factors that must be understood about the studies on which these data are based.

Prevention and Treatment

• Most problems may be avoided if the implant companies promote, and clinicians adhere to, good clinical practice.
• Better informed consent and communication among dentist, patient, and laboratory is essential to prevent unrealistic expectations for implant-supported
  restorations.
• Better case selection, knowledge of systemic problems that can result in complications, and better treatment planning
  are all essential to reduce the risk of complications. Use of available technology and diagnostic tools can aid the clinician in obtaining more predictable
  planning, placement, and restoration of implant-supported restoration.
• Familiarity with medications commonly used in implant therapy is essential to any dentist in avoiding complications at the time of implant placement, augmentation procedures, as well as post surgically.
• Knowledge, learning, and experience are paramount to reducing the number of and severity of complications that will inevitably occur.

List of references (PDF)