Causes of Dental Implant Failure – Early and Delayed Implant Failures

Dental Implants are one of the latest and most advanced treatment plan for replacing a missing tooth, with such high number of implants being placed, Dental Implant Failure is also seen. The global Dental Implant market is approximately USD $3.6 billion in the year 2020 which is a bit lower due to the COVID-19 pandemic and is said to improve in the next year. With the Market size said to increase manifold in the coming years we can see the number of implants being placed increase as well. With an increase in Implants placement we can also see an increase in Dental Implant failures which is a consequence of any Treatment. 

There can be many factors which can lead to failure of a Dental Implant, rejection by the patients body, lack of maintenance, patient not following instructions (No smoking), which can lead to failure, Error in treatment plan, etc. There are many treatments available for Completely Failed Dental Implants or Dental Implants which are about to fail. There are certain treatment protocols which can be followed to heal Failing Implants (Peri-implantitis). 

Bone loss around Dental Implant Exposing the implant Thread

First and foremost it is important to know the reason or cause of Dental Implant failure. Failures of Dental Implants can be divided into two types – Early Failure and Long-term Failure. One thing to remember is that the Initial Success Rate of Dental Implants is a very high 98.5% which and long term success rate is 96%.

Causes of Early Implant Failure: This type of Implant failure is when it happens within the first 3 months. This can be attributed to failure of bone formation around the Dental Implant which needs to happen within the first 2-3 months. 

• Rejection by the patients body
• Infection of the surrounding Soft Tissue and Bone following Implant / Crown Placement due to Poor Oral Hygiene
• Excess stress on Temporary or Interim prosthesis
• Heavy Cigarette smoking 
• Necrosis of Bone while surgery (increase in temperature of bone)
• Placement of Implant in unstable bone without proper bone mass 
• Placement of Implant in Infected bone
• Failure to ensure proper Stability of Implant 
• Lack of blood supply – poor blood supply can decrease the healing process and in-turn lead to the failure of the Implant
• Improper Flap Design after placing the implant which can lead to food impaction and infection of the surgical site. Damage to the flap can be during the extraction of the preceding tooth. (Types of Flaps for Dental Implant)
• Medications such as Bisphosphonates used in osteoporosis can increase the risk of failure
• Un controlled Diabetes also plays a major role in failure of the Implants 
• Hyperparathyroidism, post radiation therapy
• Existing infections in the adjacent teeth can lead to the failure of the Dental Implant

Causes of Long-term Implant Failure: 

Bruxism or Night Grinding or Clenching of teeth: Excessive grinding of the teeth either during the day or night can transfer the force on to the implants as excess stress leading to failure of the implant. The excess force leads to bone loss around the implant which loosens the implant and leads to failure. Such behavior 

Lesser number of Implants: When there are lesser number of implants than the required number where increased force on the present implants leads to bone degeneration. 

Cosmetic: As time progresses the gum around the cervical region of the crown starts to recede exposing the implant, this in turn gives a black appearance. It is more problematic in the anterior region. 

Peri Implantitis: Caused due to poor Oral Hygiene when Food accumulates between the Crown/Implant and Soft Tissue helping bacteria grow leading to Bone Loss and Implant failure. It is important to maintain good Oral hygiene around the dental implant to prevent Peri Implantitis.