Experts in Treating Dental Implants Complications

The placement of dental implants is currently considered as a technique of choice for permanent and permanent dental rehabilitation. However, as any surgical procedure is not without complications.

To consider dental implant failure, clinical and radiological parameters must be taken into account; It is clear that a dental implant is considered unsuccessful when it does not meet the purpose for which it was placed.

There are several factors that can affect the survival of a dental implant: patients' systemic and psychosocial factors, perioperative errors, surgical factors, prosthetic factors, patient habits, and implant design.

Even today, some unexpected or unforeseen situations arise in the surgical phase as well as in the rehabilitation or rehabilitation stage of the implant, in addition to these situations is added the problem of simple fact over time.

Usually we speak of "failure", "risk factors", "complication", etc. Thus, it is complex to systematize the different situations that can lead to unsatisfactory results in dental implantology.

Speaking of "risk factors" and "complications", we must understand that they are two very different things, but it must be made very clear that ignorance of the risk factors will result in the occurrence of complications.

RISK FACTORS

Irradiated patients:

Although not an absolute contraindication, the success rate will be somewhat lower than if the patient did not receive radiation therapy. A number of parameters should be kept in mind.

Bisphosphonates:

They produce an ANTIRESORTIVE effect, this means that they inhibit the activation or recruitment of the bone cells that are hematological cells that degrade, absorb and remodel the bones, even when these cells are in charge of removing poor bone or bone that has Lost its resistance, the fact of being altered this cell causes that they do not interact of suitable form with other elements or cells related to the correct preservation of our bones.

Diabetics:

The current criteria do not exclude patients from cases in which diabetes is controlled, the patient can respond favorably as any other patient, with good results, and without complications.

However, in diabetic patients, it is advisable that the pre-treatment protocol with dental implants and posterior control be more accurate and exhaustive.

Cardiopathy:

In patients with heart disease, a detailed clinical history should be performed, determining the dates of episodes of myocardial ischemia.

Anticoagulants:

In patients with hemostasis alterations the dental treatment they receive should be decided, ruled and controlled by their clinician at the head (hematologist or internist) and be in close communication with the patient.

Smoking:

Smoking, as we all know is harmful in all respects, so it is expected that smoking with dental implants is also especially during the process of osseointegration, increasing the risk of failure of treatment of dental implants.

COMMON COMPLICATIONS RELATED WITH DENTAL IMPLANTS:

Loss of bony anchorage (which does not maintain stability and loses or does not occur the integration).
Complications related to soft tissues (alteration or defects in gums or oral mucosa).
Post-operative pathological complications (according to the surgical technique used, the systemic compromises that the patient may have and their degree of collaboration to carry out the indications).
Mechanical surgical complications (inadequate positioning or placement). Aesthetic, phonetic and functional complications prosthetically (disproportion or projection, alteration of speech, the exercise of mastication in imbalance).

POSTOPERATIVE COMPLICATIONS OF DENTAL IMPLANTS

SHORT TERM

Infection

Most of the possible complications appear after the surgery. One of the most common is called periimplantitis, which is a bacterial infection in the area where the dental implant has been performed. Usually, the appearance of peri-implantitis is due to insufficient oral hygiene after the intervention and the symptoms are pain, bleeding and inflammation, reaching the possibility of being a reason for implant loss if it is not treated well and immediately.

During osseointegration

Implant mobility or appearance of ulcers and/or granulomas

Other possible complications may appear in the osseointegration phase, in which the dental implant is integrated into the bone. One of them is the mobility of the implant, which is usually due to an inadequate surgical technique.

Another is the formation of granulomas or ulcers in the suture areas of the flap.

If the fixation of the prosthesis of the tooth or the replaced teeth on the implant is carried out without the surgical wound healed may appear an overload on the dental implant will cause it to move when losing the anchoring function.

Nerve injury

Nerve injuries may occur during milling, for incorrect diagnostic information and/or direct compression of the inferior dental nerve during implant placement.

MEDIUM AND LONG TERM

There are patients with dental implants with more than 30 years without problems, which suggests their durability since the aim of their placement is that they remain indefinitely.

But in the medium and long term complications can also appear, including:

Those that affect the gums

Gingivitis, gingival hyperplasia, the formation of fistulas or retraction of the gums (the threads of the implants being exposed).

Mechanical Complications

Mechanical complications may also occur, which are uncommon but may occur, such as pillar screw rupture or fracture of the dental prosthesis.

CRITERIA FOR AVOIDING DENTAL IMPLANTS RELATED COMPLICATIONS

More and more patients come to our office with implants or complete failed treatments that we must withdraw.

It is essential to follow some basic criteria to achieve predictability of success of long-term implants:

TYPE OF DENTAL IMPLANT

The dental implant must be of excellent quality, scientifically supported, adequate and specific design, suitable selection according to the area where it is to be placed, avoiding that material fatigue can fracture over time, besides avoiding misalignments, fractures, bone loss, and infections.

SUFFICIENT IMPLANTS

It is important to place the patient the necessary number of implants so that there is no overload that will eventually result in a loss of bone integration or a rupture. In many cases in order to reduce costs and capture the patient, disproportionate treatment plans are suggested that will be doomed to failure.

REINFORCING THE BONE

Reinforce the bone by grafting, thinking about a future further weakening of the bone associated with the passage of time.

SPECIALISTS WITH EXPERIENCE

It is essential to be in the hands of qualified specialists in Oral Implantology or to be referred to an Oral or Maxillofacial Oral Surgeon in complex cases such as associated pathologies or alternate procedures of high complexity.