Everything You Need To Know About Dental Implant Pain Years Later


   Dental Implant pain years later sounds terrifying right !"

Let's discuss from a patient's point of view, the different types of failures and also how to prevent dental implant failures.

Dental implants have been around since the 1950s and of course they're very common practice now to replace missing teeth.

There are probably about 10 to 15 major brands of implants and really there's up to 300 individuals brands of implants that are
available in market. 

So you can imagine that even in the USA on an annual basis there are about half a million implants placed that's 500000 implants every year.

When you consider that from research papers , success rates are around about 96 to maybe 98% of implants even If we choose something in the middle say 3%  we're still going to be seeing around about 15,000 complications just in the USA alone.

There are 3 categories of failures 
1. A fracture of the  screw.
2. A fracture of the implant or 
3. Perimplantitis ie there's a problem with either the gum or the bone.

We would be discussing these infectious problems in gums with implant what we call peri-implant disease and this is very similar to periodontal disease around natural teeth.

    What causes peri implant diseases ?   

There are 2 types of peri-implant disease :

1. Primary problems which usually happens before the implant is actually loaded and this happens within the first 3 to 6 months.

This is sometimes called rejection or this is when the bone doesn't grow into the implant at times this can be painful it's usually painless actually and we do see some swelling and redness of the gum.

It happens very early on so this is just when the Implants placed hasn't had a chance to heal and usually the implant hasn't been loaded so there's no crown or bridge on top of the implant and that's what we call a primary failure.

2.  The second part is the secondary infection or a secondary failure and this is after loading so this is usually 3 to 6 months after an implant has been placed usually 3 to 10 years later. 

The implant will still look like a natural tooth and function as a normal tooth in the mouth but it has inflammation of the gum which causes pain to patient.

    What are symptoms of peri-implantitis ?   

The following are key early signs and symptoms of peri-implantitis to look out for:

1. A bony defect with a crater-like shape.

2. Redness and swelling of the soft tissue.

3. Bad taste possible if pus is present.

4. Bleeding on probing or brushing. 

5. Swollen lymph nodes.

6. Dull aching or tenderness of gums.

   What are the reasons for Implant failure ?  

The reasons for failure may be different from patient to patient.I have broadly classified it into 2 categories 

A) Implant factors. 
B) Patient factors.

A) Implant factors. 

1. The design of the crown or the bridge is actually critical it should be such that it is cleanable. If it's not designed in that way it will lead to implant failure.

2. There should be nice contact points between implant teeth so that food doesn't get stuck or plaque doesn't get caught around else it will result in failure of implant.

3. While cementing a cement retained implant  there is a possibility that cement maybe left around the implant which might be left unnoticed by your Dentist. 

It can lead to infection around the gums thats why it's very important to actually not only use the right brand of implant but have a very experienced surgeon that's placing implants in a proper manner to avoid failures due to inexperience of dentist.

4. The position of the implant is actually wrong maybe it's too deep to shallow or it is too far in the front of the mouth or maybe we have the problem where the soft tissue is not quite right around the implant leading to implant failure.

5. The last thing that a dentist can control is the implant system we look at whether it's an internal or external connection ; is that a bone or tissue level and what is the Surface of titanium ; surface on the implant itself is  very important and all of these factors will determine how long an implant will actually last.

B) Patient factors

1. The general health of patient is very important patients with cardiovascular problems or if you’re diagnosed with an autoimmune disease or conditions like rheumatoid arthritis and diabetes, 

It can cause the body to heal at a slower pace. Slow healing can prevent osseointegration, where the implant fuses or integrates with your jaw bone leading to implant failure.

2. In 2016, McGill University researchers found that heartburn medications ie proton pump inhibitors like omeprazole or pantoprozole may reduce new bone growth,

Thus affecting how an implant fuses with the jaw bone leading to more chances of implant failure. 

Also in 2016, researchers at the University at Buffalo reported results of getting implant failure 4 times more among people taking antidepressant medication like sertraline or fluoxetin.

So it’s important to discuss any medications (prescription and over-the-counter) that you’re currently taking with your Dentist.

3. Smoking can also cause dental implant failure because it restricts blood flow to the gums, slowing the healing process. Multiple research studies show that smokers can have a dental implant failure rate up to 20 percent.

4. Your generalized cleaning and maintenance is also very important for longevity of implants. 

So overall if your Dentist is well experienced your health is good & if your maintenance is good your implants will last long but if any of this is compromised there can be pain years later of implant placement.

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