July 21, 2016
As with any other surgical procedure, there are a variety of internal and external factors that cause complications or even total failure of the treatment. Dental Implants are no exception. Dental implants are designed to be a permanent replacement for a missing tooth or teeth and are a popular alternative to removable dentures or fixed bridges. They anchor artificial teeth directly into the jawbone which makes them a more functional and aesthetically pleasing restoration. That said, they are also more expensive and have longer treatment and recovery times.
While the track record of successful dental implant procedures is impressive, some patients do experience some complications. The following are a few of the possible causes and reasons behind dental implant problems or failure that you should be aware of before deciding to get dental implants or as you start the post-surgery healing period.
Success Rates
More than 95% are completed without incident (up to 98% if they are cared for properly). The majority of the problems that do occur are minor and easily resolved. If something does go wrong, consult your dentist or surgeon as soon as possible. A fast response enables them to take corrective actions before you or the implant is threatened by additional (more serious) problems, which is why it’s important to be aware of the possible complications. Other ways to improve the chance of success include finding an experienced dentist, planning the treatment schedule carefully beforehand and following aftercare and oral hygiene instructions to the letter.
Failed Osseointegration (Implant is Loose or Fell Out)
Osseointegration describes the formation of a direct functional and structural connection between a person’s bone and an artificial implant. This process takes place over the course of several months after the implant is placed. Failure of an implant is often attributed to the failure of the jawbone to fuse together properly with the implant. An implant is deemed a failure if it is mobile, falls out or shows signs of bone loss of more than 1 mm after the first year and more than 0.2 mm after the second year. Several factors can cause this to happen including incorrect positioning, insufficient bone density or volume, overloading, damage to surrounding tissues, external force/sudden impact, fractured implants or even a reaction to anesthesia. Several of these causes are described below.
Before an implant can integrate properly into a jawbone, there must be a healthy volume and density of bone present. For patients who lack adequate bone height, width or length, procedures such as a sinus lift or bone graft can help add space and bone mass, but significantly add to both the total treatment time and cost.
It’s interesting to note that the density of bone beneath missing teeth deteriorates over time since it is not being stimulated by the forces of chewing. Patients who have been missing teeth for months or years often require bone grafts before they can get implants.
Peri-Implantitis (Infection)
Peri-implantitis, or infection, can set in when bacteria is present during oral surgery or any time post-surgery without proper dental hygiene. It can also be caused by the dental cement used to secure crowns onto the abutments when it escapes from under the crown during cementation and gets caught in the gums.
It is a condition that involves inflammation of the gum and/or bone around the implant and is one of the common complications. A form of periodontal disease, peri-implantitis can cause bone loss and implant failure. It can sometimes be treated, but in most cases the implant must be removed. There are cases where it does not occur until several months or years following the surgery. Patients with diabetes, smokers, patients with thin gums and those with poor oral hygiene are at greater risk of developing the infection. Smoking in particular significantly decreases the success rate of an implant.
Nerve & Tissue Damage
Another possible but rare problem is damage to the tissue surrounding the implant, specifically the nerves. When an implant is placed too close to a nerve, patients may experience chronic pain, tingling or numbness in their cheek, gums, tongue, lips or chin. The nerve damage could be temporary or permanent and the implant might need to be removed. In almost all cases, this problem is caused by mistakes made by an inexperienced dentist.
As with other invasive surgeries, some tissue damage will occur during a dental implant procedure. Some bleeding and pain is to be expected for a couple days after the surgery, but if the pain is extreme, the bleeding excessive or they it last longer than a few days, you should contact your dentist.
Overloading
In certain cases, the oral surgeon may decide to perform immediate loading during a dental implant procedure. Immediate loading is a one-stage treatment method where the crown and abutment are placed on the dental implant right after the post is surgically inserted. The normal process consists of two stages and provides time for the implant to integrate with the bone before adding the components that protrude above the gums. Benefits of this method if problems do not occur include less post-surgical care, quicker recovery and shorter treatment times. However, this all-in-one procedure can lead to complications since implant integration is incomplete.
Overloading is the term given to failures caused by undue pressure or forces placed on the protruding abutment and/or crown. These forces can easily disrupt the osseointegration process. Patients who have inadequate bone mass may not be eligible for immediate loading.
Sinus Problems
Sinuses can be a major challenge for dental implants replacing teeth in the upper row. In addition to the presence of the sinuses, insufficient bone quality and quantity in the upper back jaw can make dental implant procedures in this area difficult.
To develop a strong bone foundation, an oral surgeon may perform a sinus augmentation. This procedure involves lifting the existing bone into the sinus cavity to create enough space that for a bone graft. The goal is to create more bone in that area in order to support a dental implant.
However, if the implant protrudes into the sinus cavity, the area can become infected and/or inflamed. An X-ray or CT scan can easily detect this problem and corrective surgery can then be performed. Patients should inform their oral surgeon of sinus issues prior to the implant procedure.
RELATED Dental Implants: What You Need to Know Before You Go
Other Risks & Causes of Failure
The following are other risks and causes of dental implant challenges for patients to consider.
Foreign body rejection – Similar to organ transplants, it is possible that a patient’s body will reject the dental implant. In this case, the patient’s body see the dental implant as a foreign object that does not belong and pushes it out.
Failure of the implant itself – Even though they are made of metal (usually titanium), it is possible for the post to bend or even break. This much less common than it was years ago thanks to advances in implant design and materials, but it is still possible. An implant can crack or fracture if it is subjected to excessive external forces. This could be a sudden impact like a blow to the face or excessive pressure over a period of time like grinding teeth or an unbalanced crown.
Allergic reaction – Most implants today are made of a titanium alloy that contains traces of nickel. While quite rare, some patients can have an allergic or inflammatory reaction to titanium. The symptoms can range from itchiness to Chronic Fatigue Syndrome. The MELISA test is the only scientifically-proven way to determine whether or not you have a titanium allergy and what the severity is.
Contraindications
In addition, there are a number of conditions and external factors that can be reason enough for a dentist to withhold dental implants from a particular patient. There are very few reasons that would absolutely prohibit implant dentistry, but the following points should be taken into consideration.
- Failure to locate a primary nerve in the lower jaw
- Insufficient bone height, width or length
- Uncontrolled Type II diabetes
- Oral or intravenous bisphosphonates
- Bruxism (tooth grinding or clenching)
- Smoking
While that might seem like a long list of highly-unpleasant problems, remember that serious problems are rare and success rates are 95%+ as long as you find a trusted dentist to do the surgery and look after your teeth. Regular visits to the dentist can help manage most problems easily thanks to early detection. That said, be sure to contact your dentist as soon as possible if you have any of the symptoms mentioned in order to prevent implant failure or at the very least avoid developing more serious health problems.
What to do if an Implant Has Failed
All is not lost if a dental implant fails. It is sometimes possible to save an implant (if help is sought quickly enough) by building up the bone & gum tissue surrounding it. However, in most cases the implant must often be removed and the area left to heal. An implant can be attempted once the area has recovered, which can take up to a year or until the dentist determines that the site is suitable. Depending on how well the area heals, a bone graft might be required to provide a better foundation for the implant and improve the chance of success.
If the implant fails a second or third time, then it’s a sign that either:
- The dentist doesn’t know what they’re doing/isn’t capable of successfully completing the procedure or
- You have insufficient bone density, an allergy or are otherwise unsuitable for implants
The best way to figure out which situation you’re in is to get an honest second opinion from another dentist to see if they think that implants will work for you and to inspect the work the other dentist did.
In the first case, there are two main courses of action:
- Ask for some or all of your money back and start looking for a new dentist.
- Consult a legal professional to determine if you have grounds to sue for negligence or malpractice.
If you fall into the second category (you are the cause of the problem), your dentist should be honest with you and suggest other tooth restoration solutions such as dentures or bridges as implants probably won’t ever work.
In either case, the most respectable dentists will refund you for the failed implants or offer you credit towards an alternative restoration. However, at the end of the day, your dentist’s responsibility depends on what it says in your agreement.
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Staff was so kind from start to finish. Dr Gorbatov was so gentle I didn’t feel a thing. My teeth look beautiful! Would recommend to anyone
erika castro
Dr. GORBATOV is the most charismatic, cheerful Dentist with tremendous energy. Today I can confirm that he is the best dentist in Florida. He had been looking for a good...
Myriam Harter
Absolutely the best doctor and staff. I was afraid of any and all oral procedure. Dr Gorbatov did all my oral surgery without any pain involved. I do not even...
Sharon Shields
Hello, Dr.Gorbatov is truly THE BEST ,so please just forget about all the rest! I truly witnessed MIRACLE IN MAKING!!! My sister now have a MOVIE STAR SMILE! Thank you...
Valnea Del Bianco (Hallandale Beach, FL)
I are retired dentist and visit dr Gorbatov,s office like a patien for dental works. We graduate the same school New York university and l can tell you the dr...
Shmuil Aronovich (Hallandale Beach, FL)
The dentist fit me in last minute when my normal dentist was unavailable I tried them on the recommendation of a friend after I broke a veneer and had 3...
Mark Krawiec (Hollywood, FL)
I want to say that this office and the staff are by far the best professionals in dentistry in Hollywood!! they become family!! I want to thank you all for...
norma masoud
I’ve been coming here for almost 10 years now and can surely say that the customer service provided is one of the best in town. Make sure to be nice...
Hype Kay (Royal Palm Beach, FL)
I absolutely loved my experience with Dr G and his amazing staff 🌸 so very welcoming and thorough 🌸🌸🌸
Kelly Spillman
I finally found a great dentist who does its all, root canals, caps, and implants. I needed major work on my mouth all at once, although it was expensive because...
Diane O’Brocki (Loxahatchee, FL)
Dr. Gorbatov is an excellent dentist whose main priority is making sure his patients are comfortable and get the best dentistry he can offer. He provides an attentive service, and...
Natallia Harbacheuskaya (Hollywood, FL)
Great experience! Really felt like Dr Gorbatov and his staff took time to explain and perform my procedures on a very short notice. Highly recommend!
Suzanne Ireland
Dr. Gorbatov placed an implant for me, I am extremely happy with the result, I had absolutely no pain during the procedure after few month doctor put a crown, looks...
Sergey Kasatkin (Sunny Isles Beach, FL)
I was very fortunate to find Dr. Gorbatov right when I had a major issue with an old crown that fell off and led to a major infection just a...
Octavian Miron (Aventura, FL)
I recommend this place to anyone that needs any type of dental work done , I always feel welcome from the moment i sign in untill my visit is over...
Lyn F (Wellington, FL)
Friendly and the caring stuffOK gentle professional careComfortable and election dental experience
Albert Volchek
My experience, couldn’t ask for any better, great office, wonderful people. Professional in his field, with pleasant energy in his office Dr. Gorbatov and all his team members where AWESOME!!...
William Hunt
My experience was great.Doctor is very professional.I really recommend.The best place to go for your dental.
Olga Meverden (Sunny Isles Beach, FL)
Great office. Dr. Gorbatov is an excellent dentist. The staffs are really nice and helpful.One of the best experience. Highly recommend.
Phicha M
Dr. Gorbatov's office equipment and services represent highest professional standards in the industry. All procedures and cost are explained in details in layperson language. The doctor and the assisting personnel...
Elena Levitskaya
Amazing experience! The office is beautiful, the staff is knowledgeable and super friendly.
Maria Slomka
Dr. Dmitry Gorbatov and his team provided an exceptional dental experience. Their attention to detail, gentle approach, and thorough explanations made me feel at ease throughout the procedure. Truly a...
LANA C
I've been going here for a few years now. I'm a periomaintenance case, so I'm in four times a year. The hygienists do a great job, provide me with excellent...
Devin Scheller
Well I’ve been going to Dr. Gorbatov since 1996.... Yes ! I’m a loyal. With all the dental issues I’ve had, he’s been able to resolve them and been keeping...
Burke Crump (Wellington, FL)
Top-notch and high-quality services are provided at Dr. Gorbatov’s office. Since my last visit, I can't stop smiling ever after. I think I found the dentist for life. My highest...
Val Lovechild
Great staff I was nervous but they made me feel at ease. I am confident that they will give me the smile that I airways wanted. The receptionist personality is...
Uuggh uggh (West Palm Beach, FL)
I'm very thankful with the doctor and the entire office staff. Very professional work and excellent treatment.
Guillermo Ricard
Fantastic service. Dr. Gorbatov is very skilled, and make your experience such a pleasure. Definitely go to Dr. Gorbatov for your dentistry needs.
Raul Alvarez
My experience was very smooth. When I called for appt, the next available time was in two days, I didn’t expect it will be that soon.Everybody in the office is...
Daria Tis
The best doctor and very kind team❤️The best New Special Cleaning with Air - Flow! Amazing👌🏻😀
Victoria Volkova
Absolutely loved the staff and doctor! Right when you walk through the door they greet you with such a big smile and kindness. Thank you doctor I will never stop...
epasco12
This is the best dental office!!!. Everyone is very nice and professional. Dr Gorbatov and the Hygienist Lilia have golden hands. No discomfort at all. I Highly recommend Dr Gorbatov...
Al Chaviano
I am extremely happy I found Dr.Gorbatov! He saved my vacation and helped me in emergency mode(I broke my front tooth) I am changing my dentist to Dr.Gorbatov, convenience, no...
Tatiana Vaccaro
I’m very grateful for the work that Dr. Gorbatov did! Very professional and knowledgeable.Highly recommended!☺️
V P
I love this place. The staff is wonderful...friendly and very accommodating! I highly recommend.
amanda powell
Absolutely amazing. Jess and Jessica at the front made me feel so comfortable and helped me conquer my fear of the dentist. The office is clean and welcoming I completely...
Hayley Kaplan (Wellington, FL)
Very happy with quick service, suggestions & prices. Will be a repeat customer
Jaclyn Franceschini (Fort Lauderdale, FL)
FIVE STARS! I left my pre you’d Hollywood dentist because she refused to do a simple noninvasive ADA recommended preventive treatment, and insisted I needed an implant. In addition her...
therese costa
Most beautiful veneers ! Dr. Gorbatov is the most talented doctor ever !Air flow cleaning is the best in their clinic ❤️
Julia Zhguleva
It was my first visit to this clinic and I am soooo happy I came here! The doctor Dmitry Gorbatov big professional and wonderful person! Hygienist Lilia is the best!!!...
Tatyana Rodina
I switched my dentist because i was dissatisfied with their service and decided to go to Dr.Gorbotov's office for my wisdom tooth extraction. I never thought I would see the...
Oleg Solovey (Sunny Isles, FL)
Amazing service! The team is in top of what they are doing. I had two emergency root canals needed retreatment and Dr. Gorbatov and his team meticulously saved my teeth...
Yuliia Vienikova
Dr. Gorbatov and staff are WONDERFUL! Highly skilled, innovative, up to date with the most updated technology. The entire staff is warm, friendly, kind, and extremely helpful. I came across...
Dr. Dee
I just moved from California and immediately fell into the "trap" of Dr.Gorbatov. Was very pleasantly surprised. Firstly, a knowledgeable sociable Doctor with "golden hands". Secondly, the wonderful staff, especially...
Naum Berdichevsky
Dr Gorbatov is an amazingly talented dentist. I had the porcelain veneers done in his office and have a feeling like I have never had such beautiful smile in my...
Julia Soldatova
Wonderful service! I recently had a dental cleaning for the first time at Dr. Gorvatov Dentistry. The whole process was smooth and relaxed. Their office environment is pleasant and the...
Karol Rodriguez
Thank you personally and from the bottom of my heart for the kindness and consideration you showed my mom, Catherine the other day! ?
Patrizia Rondelli (Hollywood, FL)
Amazing doctor and very friendly and professional stuff! Definitely the best doctor in Miami!
Lily AA
Everyone was kind, Professional and very concerned for my best interest and well being. They double check everything to make sure it is correct. Dr. Gorbatov is a first class...
Mark Krawiec
Let me start by saying Dr Gorbatov is amazing, a true credit to the art of dentistry. He is a perfectionist and his assistant Lidi is amazing also in her...
Keith Miller
Great service Knowledgeable doctor Friendly staff 5+ stars!! Someone hacked into my account and gave false review. Not me!!! Outstanding service @ Dr Gorbatov Dentistry!!!!
Ellen Zlobinskiy (Hallandale Beach, FL)
I had an amazing experience here. Lily the hygienist is the best she’s so nice and didn’t stop until my teeth were perfect. I love her I’ll be back soon...
Auto Sales
For me, dental work always came with the presumption of pain and discomfort. That's why it was always very difficult to get any recommended work done, because all I'd have...
Iry T. (Hallandale Beach, FL)
Excellent Care, Excellent Costumer Service, Good quality office, and Professional Doctor.
Zbigniew Krawiec
I am grateful to reach the hands of Dr. Gorvatov,my dental surgery has been successful, he was very professional when deciding what to do with my tooth, thinking about the...
EP TECH USA
You are the best guys! You definitely make me smile more :) Thank you sooooo much! Olga Aksenova ❤️
Olga Axenova (Hallandale Beach, FL)
When I first found this office I was terrified of the dentist and I had constant anxiety when seeing dentists. Now I look forward to cleanings and my anxiety is...
Hayley Kaplan (Wellington, FL)
I came to Dr. Gorbatov as a referral and everyone has been so friendly, kind, helpful and understanding about my nervousness. I greatly appreciate everyone’s kindness during both of my...