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All About Implant Restoration
Boise, ID


Dental Implant Diagram used by Boise DentistDental Implants is a hugely successful restoration, but problems can arise. When a dental implant fails, Dr. Geoffrey Herzog can take steps to restore the area improving your health. At Water's Edge Dental, our staff is trained to recognize the problems associated with your dental implant and work with the patient to find the best solution taking the patient’s physical and aesthetic needs into consideration.

What is a dental implant?


A dental implant is a metal post that an oral surgeon can surgically place in your jawbone to serve as a new root for a false tooth. When a patient has lost a natural tooth, a false tooth requires stabilization to stay in place; this can be from external sources such as the placement of a dental bridge, a partial denture or a full denture. The only internal source for stabilization has been the advancement of dental implants. If placed correctly, a dental implant will fuse with the bone becoming an extension of the bone. Once healed, your dentist can then place the customized dental appliance, which can be a single tooth restoration or multiple teeth restoration, over the implant.

If you had your dental implant placed by an oral surgeon and are experiencing pain, discomfort or if the implant just doesn’t seem to feel secure, Dr. Geoffrey Herzog can help. There are several factors that can lead to implant failure; we can review your needs and evaluate your implant to restore your health.

Reasons a Dental Implant Can Fail


Based on decades of research, overall the reported rates for dental implants has shown high rates of success. Nevertheless, failures do happen, and when they occur, they mandate immediate attention. There are some predictors that can be observed before placement that can point to the success of implantation. Your oral surgeon will want to take note of patient related factors such as the patient's general health, the amount of available bone for implantation, the patient’s comprehensive oral hygiene and the location of the implant.

In most situations, implant failure is the result of multifactorial limits. The most commonly listed reason for failure is contaminated tissue or tissue that has been exposed to bacteria; another common reason is the poor quality of bone leading to a lack of stability. If your dental implant causes clinical symptoms, including continuous pain, fever, nausea, other signs of infection or when your implant does not seem to be stabilizing, then the implant is considered faulty and requires attention.

Some of the common reasons a dental implant can fail include:

•  Periodontitis: Periodontitis can significantly increase the risk for implant loss, through the loss of supporting bone, and postoperative infection. Before the initial placement of your dental implant, your oral surgeon will want to ensure that the patient is not suffering from constant periodontitis. Periodontitis is an active infection of the gum tissues. This comes from plaque, tartar or calculus gaining access to the soft tissues below the surface of your teeth. Plaque, and its dried form is known as tartar or calculus is filled with active and decay causing bacteria. When it comes in contact with our soft tissues, the result will be an infection. Your soft tissue will react with irritation, often to the point of bleeding, varying levels of discomfort, and when severe the pulling back or atrophy of the gums and supporting bone. Before your implantation, your oral surgeon will need to decontaminate the surface of your gum tissue, ensuring that the surface is fully detoxified, especially during surgery. Introducing infection causing bacteria to the surgical site can result in devastating effects. If infection occurs, Dr. Geoffrey Herzog can help, and time is of the essence.
•  Malpositioned Implants: Having your dental implants placed by someone who knows what they are doing can be vital to their success. Too often dentists are placing implants without the use of Cone Beam radiography, or they are participating in a limited course on various topics and then begin practicing the techniques they learned. In both situations, the placement of your dental implant can be off, even if just slightly.
•  Marginal Bone Loss: If the patient has poor dental hygiene, leading to an excessive amount of plaque around the dental implant, there will be a loss of bone, also known as a loss of osseointegration. This bone loss can lead to the destabilization of the dental implant. This is associated with persistent gum disease or periodontitis. Osseointegration is the act of the implant device fusing to the bone. This natural process is vital to the success of the implant. If the patient loses bone due to infection from plaque accumulation, then this important fusion is lost.
•  Smoking:Patients who smoke are at an increased risk of experiencing implant failure. Smoking tobacco causes momentary paralysis to the tissues in your mouth. This paralysis will limit your ability to heal properly and then cause a failure in the osseointegration process. Dentists may advise the patient to stop smoking for a certain amount of time before surgical placement, but if the time is not long enough, or if the patient does not adhere to the restriction of tobacco use. A 2014 study on implant placement in patients who smoke, confirmed that smoking pointedly affected the overall failure rate, it also put the patient at an increased risk of postoperative infection, and in experiencing marginal bone loss.
•  Short Implants: Implants that are less than 10mm in length have an increased likelihood of failure if the area is not prepared correctly. When placed by an oral surgeon who is familiar with the implant, shorter implants can have comparable success rates can be achieved with short implants as those with long implants by decreasing the lateral forces to the prosthesis, eliminating cantilevers, increasing implant surface area and improving implant to abutment connection. Continuing studies have shown that stability is best in implants that are longer, ideally 13-15 mm is most recommended.
•  Brand: Though the failure rate of dental implants is very small, there are certain brands of dental implants that have displayed a small amount of an increased likelihood of failure. These brands are involved in ongoing and continuing studies.Clinician Inexperience: A significant reason for implant failure is due to clinician inexperience. Dental implants have become a very popular restoration because of its highly successful results
•  this has induced increasingly more and more dentists to want to participate in this restoration. There can be vastly different results based on your dentist's knowledge and experience in this restoration. Having your work done with a dentist who is familiar with surgery is best.


Signs or Indications that you Implant is Failing


The placement of a dental implant is a highly successful restoration, but failure can occur. There are three general indicators that can signal trouble, and if you experience any of the following indicators, it is best to seek treatment from a dentist who knows what to do such as Dr. Geoffrey Herzog.

Three indications of Dental Implant failure include:

•  1. Feeling Pain:Pain is a sign from your body designed to indicate that something is amiss. There is a certain period that pain can be expected, but the pain that has continued for an extended amount of time, or pain that seems out of the ordinary can be an indication of a larger problem. Another type of pain to be aware of is after the pain of surgery has ended, and then pain suddenly returns. This can be an indication of a larger problem and should be reviewed by a professional immediately.
•  2. Swelling or Inflammation:Immediately following surgery, the patient will experience some level of swelling. If this swelling turns into inflammation, feeling hot to the touch or red in color, this can be an indication of infection and the patient should seek immediate care.
•  3. Loose:The intention of surgery is for the dental implant to stabilize in your mouth. If after a reasonable amount of time post surgery the implant does not feel firm, or secure, in your mouth, this can be an indication that something has gone wrong. If the implant felt stable but has since loosened and is now wobbling in your mouth, this can be an indication that something has gone wrong. Medical intervention with a dentist like Dr. Geoffrey Herzog, is needed.


Restoring your Dental Implant


If you fear that your implant has failed, take action sooner rather than later. Implant failure can lead to damage to your jawbone and your health; we would rather see the patient and put their mind at ease, then have a patient suffer silently as an implant fails.

Dr. Geoffrey Herzog can restore your dental implant following failure. Working with our team at Water's Edge Dental, we will diagnosis the problem and help the patient make a decision on the best way to resolve the situation taking their health needs, financial needs, and desired end results into consideration.

The replacement of a dental implant that has failed involves the challenge of achieving osseointegration after the area has already been compromised. We will want to predict the long-term success in the planning phase, which will include an evaluation of the patient’s health and any medications that they are taking. The predictability of successfully replacing the failed implant will help determine the next steps. We will want to reach a solid treatment plan and informed consent from the patient before the subsequent attempt.

Decontamination
The surface around the area needs to be decontaminated from infection causing bacteria. This can be done with laser treatment, along with debridement, which is the removal of contaminated tissue or debris from a wound, this is commonly done through scaling. Dr. Geoffrey Herzog needs to be meticulous in the removal of granulation tissue from around the failed implant site.

Change the Implant
In some situations, where the implant has been unable to fuse through osseointegration, or if osseointegration has been lost, we may need to set a new implant in replacement. The new implant may be wider or longer based on the needs.

Guided Bone Regeneration
Guided bone regeneration is a technique that we can use to facilitate bone regeneration, thickening the area of the bone when the thickness of the jawbone was insufficient for proper implant placement. The area around the implant is packed with the patient’s bone, known as an autogenous bone replacement and the area is then covered with a special membrane containing fibrin and platelets from the patient. This attempt is done to establish a larger bone density, providing the needed space for the implant to be able to anchor to.

Medical Review
A common failure in implants is as a result of the patient’s medical status. There are ailments that can severely impact the patient's ability to heal properly. The use of tobacco products, if the patient is undergoing cancer treatment, and if the patient is suffering from out of control diabetes can all lead to a failure in healing properly. Besides ailments, there is some medication that can slow the patient's ability to heal. We will want to be aware of all medical disorders and possibly work with you personal physician to put you on track for increased healing.

Implant Removal
In some situations, a patient just may not be a candidate for dental implants. From continual contamination to medical disorders, the end results may be the need for the removal of your dental implant. In this situation, other options using external anchors for tooth replacement will be discussed.

Failure of your dental implant can occur immediately after placement or after having a successful implant for years. For your oral and overall health, it is always best to seek medical attention at the first sign that anything may be wrong. We are happy to review your implants regardless of how long it has been since your implant surgery.
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