In 2020, tooth replacement procedures have become incredibly commonplace.  Dental implants, in particular, have become a very popular and sought after procedure. Other tooth replacement strategies like dentures and bridges have generally become less favoured. Dental implants feel almost like your own tooth and stay in your mouth while dentures need to be removed before you sleep. Dental bridges involve cutting down adjacent teeth to hold the “fake tooth” and can damage the nerves in the adjacent teeth. A dental implant on the other hand exists as an independent unit. Done successfully, dental implants can remain in good condition in a patient’s mouth for up to 20 to 25 years! 

Dental implants are permanent tooth replacements which are designed to fuse with your jaw bone in a process known as osseointegration. They are meant to serve as both an aesthetic and mechanical replacement to your teeth and are meant to be comfortable, convenient and long lasting.

However, in a low percentage of cases, there are some situations where complications might arise during or after the dental implant procedure is completed. While these complications are rare (and experienced dental surgeons are very adept at avoiding such situations from occurring), it is important for both patients and dental surgeons alike to understand and recognize them so that the necessary precautions can be taken beforehand to avoid them.

Intraoperative complications

These are complications that primarily happen during the actual operation itself. These are considerably rare and can be largely avoided through proper pre-operative planning as well as precise execution while performing a dental implant procedure.

Blood vessel and nerve damage

Blood vessel and nerve damage can occur during the actual dental implant procedure itself and thus the dental surgeon will need to examine you and take an Xray or use a digital computer topographical technology to elucidate the blood vessels and nerves before we schedule you for surgery. Nowadays we are also able to fabricate computer guided surgical stents to further enhance the safety of the surgery.

If nerves are injured during surgery, the patient will likely suffer a degree of neuropathic pain which can greatly affect their sleep and their quality of life. Injury to this nerve can also cause numbness to the jaw. The nerve most usually compromised in this case is the inferior alveolar nerve, and is responsible for our sensitivity to external stimuli like temperature and pressure. Unlike damage to skin and tissue which generally heal over time, nerve damage can be difficult to reverse (2). Damage to blood vessels during the procedure may cause excessive bleeding during the surgery.

By using x-rays and other digital computer topographical technology, experienced dental surgeons are largely able to avoid causing any form of intraoperative complications to the patient embarking on dental implant procedures.

Lack of stability of the implant fixture during placement

In order to insert the implant, sufficient bone volume and density is required in order to keep the implant strong and stable. 

For patients who do not have sufficient bone volume to sustain an implant safely, bone is grafted from a donor site or other sterilized bone graft materials prior to the dental implant surgery. When the bone has solidified, the implant fixture can then be successfully embedded in the new bone.

If there is insufficient mineralisation of bone, especially in patients with soft bone conditions like Osteopenia or Osteoporosis, there might be difficulty engaging the implant fixture in the soft bone and the implant might not be stable. In this case, we will have to stop the surgery, allow the bone to grow back hopefully stronger and attempt the implant surgery at a later date.

Post-operative complications

Even after the completion of a successful dental implant surgery, aftercare and good oral hygiene habits are imperative for the dental implant to remain stable and healthy for a long period of time. Always consult thoroughly with your surgeon and follow any aftercare procedures closely to give yourself the best chance of making your dental implant surgery a success.

Chance of Infection

As dental implants are surgical in nature, there is always going to be a risk of infection. The chances of infection occurring is also a lot higher if you are a smoker or if you don’t practise proper dental hygiene after the procedure.

The infection of the treatment site can sometimes occur as an abscess near the site due to the accumulation of bacteria. Hence, some dental surgeons will prescribe their patients with a course of antibiotics after surgery to avoid this from happening. Although studies show that prophylactic antibiotics for each implant surgery is not mandatory, Antibiotics are still useful in preventing postoperative infections after implant placement. (1)

Infection is particularly dangerous as it could spread to other parts of the body, causing a fever and affecting other bodily functions. It is extremely important that patients follow their surgeon’s instructions for aftercare in order to avoid this from happening. Treatment for infections will depend on how severe the infection is and where the infection is located.

Breakage of the implant due to long term excessive force

This is a common complication that should not be overlooked. Much like how sometimes teeth can be chipped due to accidents while playing sports, any form of excessive impact can possibly damage the dental implant crown, screw or even injure the bone underneath, leading to instability.

For some patients who have bruxism (teeth grinding during sleep), they could be damaging their dental implant nightly without being fully aware of it. If you suffer from bruxism, you should consider wearing a mouth guard or mouth shield at night in order to prevent your dental implant from sustaining any long term damage.

Although dental implant procedures do present with risks, it is important to remember that most dental implant procedures will be successful. Should there be an unlikely event where the dental implant fails, you will likely need to have the implant removed and the bone around the treatment area cleaned up. After 4 to 6 months of healing, you will be allowed to opt for the procedure once more should you so choose.

References

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5074034/
    Hemchand Surapaneni, Pallavi Samatha Yalamanchili, Md. Hafeez Basha, Sushma Potluri, Nirupa Elisetti, and M. V. Kiran Kumar. Antibiotics in dental implants: A review of literature. J Pharm Bioallied Sci. 2016 Oct; 8(Suppl 1): S28–S31.
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3413988/
    Ken-ichi Fukuda, Tatsuya Ichinohe, and Yuzuru Kaneko. Pain Management for Nerve Injury following Dental Implant Surgery at Tokyo Dental College Hospital. Int J Dent. 2012; 2012: 209474.