Dental Implant Risk Factors We do hundreds of implants every year and we always have a good stock of implants at hand. Nevertheless, we actually advise some of our patients not to do implants. This doesn't always sit well with our suppliers. To them, every missing tooth can be replaced with implants. That's easy for them to say as they don't have to face the music when something unpleasant happens. Sure, they can argue that failures occur because the practitioner is not skilled enough (which is true sometimes), but even the most experienced and talented implant practitioners suffer from all kinds of complaints. The problem really, lies in the fact that no implant system in the world is perfect (some "branded" systems are full of design flaws) and not everyone is a suitable candidate for implants. Let's take a look at some of the common failures in implant dentistry. 1. Implant "rejection"/failure of implant to integrate. 2. Implant integrates but fails after some time. This is often seen in mini implants. 3. Bone resorption around implant. 4. Implant or its components fracture. 5. Irreversible injury to the patient's nerves and other vital structures. 6. Unaesthetic restoration. Most manufacturers of implants "guarantee" that the fixture integrates. If it doesn't, they'll replace the "defective" implant with a good one. That offers some assurance, but if implant treatment is so expensive, patient expectations are often higher. Replacement of implant means going through a second surgery. We've looked at the common failures. Now what are the risk factors that contribute to these failures? 1. Insufficient bone, complicated grafting surgery. This is the most common problem seen in the clinic. The narrowest standard implant available is usually about 3.5mm in diameter. To have 1mm of bone surrounding the implant, the bone must be at least 5.5mm thick. Such bone width is seldom seen patients who have lost their front teeth for several years. Chances of finding adequate bone width are even slimmer if it was gum disease that robbed you of your teeth. Bone grafting may address this issue, but complicated bone grafting procedures are prone to failures. 2. Smoking, poor oral hygiene, nutrition, drug use. Smoking deprives the tissues of oxygen and delays healing. Poor oral hygiene increases the chances of infection. The use of certain drugs will inhibit bone growth. 3. Illnesses like diabetes, autoimmune disorders. Diabetics are prone to infections. Implants are vulnerable to infections during and even after integration. The use of steriods in arthritis and autoimmune disorders can also affect the outcome of income treatment. 4. Involuntary tooth grinding during sleep, deep bite. Stressful lifestyles can lead to tooth grinding or bruxism when sleeping. This grinding may produce forces much higher than normal chewing force, placing great stress on teeth and implants. Teeth may yield a bit to these forces, but implants are rigidly stuck to bone. There is no elasticity and they fracture. 5. Patient non-compliance. Many implant patients do not follow their dentist's instructions. For instance, dentures may not be worn over a grafted area. 6. Operator inexperience. Any dentist can place implants and many implant suppliers are only too eager to sell. It should be noted that implant treatment can be complex. Most of what experienced practitioners know are actually acquired through experience. Seminars and even courses, especially free courses sponsored by implant suppliers, are targeted more towards selling implants than providing insights to clinical realities. Implant packages are expensive. Many dentists who have just bought up a huge package would often be too eager to place implants to recover costs. At New Age Cosmetic Dentists, we still do dentures and bridges because we recognise the fact that not everyone is a candidate for implants and we've also recovered our initial investments in implants.