Patients Ask Dr. Jamie Alexander about Dental Implant Complications

Jamie J. Alexander on August 12, 2015

How common are dental implant complications?

Dental implant complications occur with some prevalence. A 2006 study found that ten years after dental implant treatment only 50% of dental implant patients described not having complications. The longer a prosthesis had been fixed to an implant, the higher the incidence of a complication.

A 2010 study found that with an increasing number of general dentists, prosthodontists and endodentists placing implants, instead of referring their patients to a surgical implant specialist, there had been a significant climb in failed implants. This is thought to be because non-oral surgeons had been attempting complicated dental implant cases for which they were not trained.

In my own practice, I see the results of poorly planned and executed dental implants. There has been an increasing frequency in new patients walking in looking for functional and aesthetic rehabilitation after implant treatment that wasn’t optimal. Fortunately, many complications are reversible, and if they are not, there are creative ways to remove an implant and still restore the bite and smile in another manner. Today, the range of possible treatments is truly amazing.

What types of dental implant complications can occur?

Complications can range from too little bone tissue to hold the implant, sensory damage to adjacent teeth, loss of sinus and jawbone tissue, periodontal infection known as peri-implantitis, malpositioning, and esthetic problems due to bone recession and/or inadequate gum tissue.

In the case of an inexperienced clinician, inadequate bone preparation, improper components, inadequate consideration of the soft tissue, and poor positioning of implants may make prosthetic restoration difficult, unaesthetic, or functionally compromised. Sometimes implants have to be removed. Sometimes, experienced oral surgeons need to step in and treat complications prior to subsequent dental restoration.

Can dental implant complications be avoided?

No matter what the cause, just the significantly increased number of dental implants being placed over the last ten years has raised the probability of more complications occurring. But, the success results reported by dental implant manufacturers are as high as 98% based on studies of implants placed by experienced oral surgeons.

So, yes, complications can be avoided or at least minimized when patients choose the recommendations and care of experienced oral surgeons who have trained extensively in dental implants. For this reason, I refer my patients to an experienced oral surgeon for the surgical steps involved in dental implant treatment. He and I collaborate in the individualized planning of my patients’ dental implant therapy to achieve the best patient experience and implant results for each individual patient.

My preferred oral surgeon is exceptionally well trained and experienced in socket preservation, bone grafts and sinus lifts if bone enhancement procedures are indicated. Once we are confident a patient’s bone tissue is adequate, the surgeon and I agree it is time to place the implant(s). We plan together the type of implant and its optimal position. I oversee the design and fabrication of the prosthesis with my preferred lab, and I work with the implant surgeon to plan any gum tissue surgery that will optimize the aesthetic appearance of the gum tissue surrounding your prosthesis.

Major complications can be avoided if you are expertly evaluated and determined to be a good candidate for implant therapy. Even so, we are all individuals with unique oral and systemic health circumstances. There is no guarantee a complication will not occur. Just the introduction of a pathogen in a surgical site can cause a minor complication requiring additional treatment.

That being said, complications can be minimized and effectively treated when every step of your implant treatment is meticulously planned and executed with the most appropriate type of implant and components, adequate time for bone and soft tissue enhancement, optimal placement of the implant, adequate time for full osseointegration of the implant and proper gum tissue healing, custom fabrication and placement of an optimally functional and aesthetic prosthesis—and also oral hygiene is carefully maintained. Patients should expect dental implant treatment to take around 5 to 6 months from start to completion.

Do you recommend dental implants?

Absolutely yes! Today’s dental implant materials and methods of restoration on implants have so improved that today’s prosthetic teeth fixed on implants can be expected to last longer than 10 years. With proper home hygiene and oral health care, today’s fixed restorations on implants can even last a lifetime. We cannot say the same for dental crowns, bridges or dentures.

Because implant materials and methods have so improved, I encourage patients who have been told they cannot have implants or who were disappointed by past treatment, to consider implant treatment today. The current dental implant materials and methods, when optimally applied, can transform your life. I plan my patients’ implant treatments in collaboration with a preferred surgeon and lab to not only succeed but also last.

What else should I know about implant complications before I agree to dental implant treatment?

Anyone placing or restoring dental implants needs to be prepared for complications. Patients should consider with their dentist or dental specialist the complications that might occur, given their current oral health, and they should be selective about going to clinicians who are exceptionally well-trained and experienced in implantology.

When dentists collaborate as I do with a top implant surgeon, you are assured that two minds are working to make sure the recommended treatment plan is the best treatment for your circumstances. When patients gravitate towards quick fixes and least cost, they are oftentimes putting themselves at greater risk for complications.

My philosophy of care very specifically guides me to do what is in my patients’ best interest. So, my treatment plans take time to prepare and are thoughtfully worked up before I present them. In the case of dental implants, I consult with and refer to my preferred oral surgeon who is patient centered like I am. When I recommend treatment that includes dental implants, you can be sure I have thoroughly examined all the possible complications that could arise and developed a treatment plan to avoid complications or at least minimize them should they occur. I want the experience you have and the results achieved to be optimal in every way.