Miami – Dental Implant Failure Treatment

While a dental implant is essentially an artificial tooth root that is meant to last a lifetime, failure does happen; however, it is rare, occurring only 5 to 8 percent of the time. In the event that an artificial root does fail, contacting an experienced specialist like Dr. William P. Lamas is essential. A specialist can determine what caused the failure and then perform a procedure specifically designed to correct the problem.

Dental Implant Failure: Defined

The word ‘failure’ can strike fear in patients and dentists alike because it means that something meant to solve a problem was unsuccessful; however, keep in mind that if a failure does occur, chances are that repair is possible.

When a dental implant fails, one of the following scenarios has occurred:

  • The artificial root is no longer attached to the jawbone, which causes it to become loose or fall out.
  • One or more of the parts have broken or cracked (e.g., the crown, denture or bridge).

Here are the symptoms that patients should watch for:

  • Receding gums around the implant
  • Inflamed gums
  • Discomfort or severe pain
  • A loose artificial root
  • Difficulty biting and chewing

If a patient has any of these symptoms, seeking treatment from an experienced professional is essential to preventing further oral health problems.

Stages of Implant Failure

Early Failure

If artificial root fails within the first four months of insertion, the treatment has failed before integration has occurred between the patient’s jawbone and the implant (i.e., osseointegration).

Long-Term or Late Failure

When this tooth replacement treatment fails from one to 10 years following the procedure, it is considered to be a late or a long-term treatment failure. A variety of factors can contribute to the onset of long-term failure, including gum disease or injury.

Reasons for Failure

Since there are various reasons that an implant may fail, there are also numerous repair procedures that Dr. William P. Lamas uses at his office in Miami to correct these issues. The cause of the failure determines which of the repair options he will need to use.

Inadequate Gingival Tissue

The amount of gingival tissue (i.e., gum tissue) a patient has will determine how well it seals around the artificial root/abutment collar. The more gum tissue, the better. Therefore, when a patient does not have an adequate amount of tissue, the artificial root may become loose.

Unsuccessful Osseointegration

Osseointegration is the term used to describe the development of a functional and structural connection between the artificial tooth root and the patient’s jawbone. This osseointegration process occurs over a period of several weeks or months following insertion of the artificial root. When an implant fails due to unsuccessful integration with the jawbone, it becomes unstable, shows signs of bone loss and/or eventually falls out. If osseointegration fails, a patient may experience discomfort and have difficulty chewing.

There are numerous factors that can lead to osseointegration failure, including:

  • Incorrect positioning of the artificial root
  • Insufficient bone density
  • Overloading
  • Damage to surrounding tissues
  • Fractured posts
  • Trauma

Peri-Implant Mucositis and Peri-Implantitis

Peri-implant mucositis and peri-implantitis refer to the two stages of an inflammatory process that destroys the gingival tissue and alveolar bone that surrounds the artificial root.

Peri-Implant Mucositis

This is the first stage of the inflammatory process, affecting only the gum tissue surrounding the artificial root. If this disease is caught in time, it is reversible.

Peri-Implantitis

If mucositis is disregarded, the infection in the tissue beneath the marginal gingiva and the surface of the artificial root provides the bacteria a pathway to the alveolar bone, causing the bone to recede/reabsorb. If severe implantitis sets in, reversing the pathology is difficult. Laser treatment or surgical intervention is often required. If repair procedures are unsuccessful, the patient will lose his or her dental implant.

Causes of Peri-implantitis:

  • Excess dental cement

    – the infection may begin forming during the initial surgery itself or once the surgery is complete. Sometimes the dental cement that is used to affix the prosthetic tooth (crown) to the abutment can get caught in the gums, this can lead to inflammation and the onset of mucositis.

  • The artificial root itself

    – if the design of an artificial root’s surface is flawed, the ability of the jawbone to integrate with it may be compromised. This defect in the surface of the implant allows micro-movements to occur, which creates a gap between the bone tissue and the artificial root. If the bacteria reach this space, infection may result. While implantitis is sometimes treatable, in the majority of cases, repair will require removal and replacement.

  • Plaque biofilm and bacteria

    – poor dental hygiene is one of the main reasons that this infection process develops. Brushing and flossing following each meal (or at least twice daily in two-minute intervals), and using an alcohol-free antibacterial mouthwash that contains either hydrogen peroxide or chlorhexidine gluconate can prevent this inflammatory disease. In addition, Dr. Lamas recommends that his patients invest in an electric toothbrush and a water flosser because these devices effectively clean the teeth, and stimulate the gums.

Common symptoms of this infection process:

  • Red, inflamed and painful gums that bleed easily

    – these are the initial signs of mucositis. This inflammation and bleeding occur in the tissue surrounding the affected implant while flossing, brushing or at random, without any stimulation whatsoever.

  • A bad taste in the mouth

    – as the pus begins seeping out of the pockets that have formed in the gingival tissue, the individual will notice a bad taste in his or her mouth.

  • Gingival recession and/or discolored-looking gums

    – the inflammation associated with this disease can cause gum recession, eventually exposing the head of the artificial root. In addition, the gingival tissue may appear bright red or purplish blue.

  • Swollen glands in the neck

    – if the peri-implantitis is severe, the glands in the neck may become inflamed and the affected tooth will be loose.

  • Halitosis

    – bad breath due to odor-causing bacteria.

Are There Always Symptoms with This Infection?

Not necessarily, many times patients do not experience any symptoms whatsoever, which is why it is crucial for patients to maintain good oral hygiene and remember to have their biannual cleanings.

An Initial Consultation at Lamas Dental Specialists in Miami

Dr. William P. Lamas will want to know about the patient’s medical and dental history; therefore, patients are encouraged to write this information down and bring it with them to their appointment. If the patient takes any type of medication (prescription and/or over-the-counter) this information will also be requested: Allergies to latex and medications will be discussed as well. Patients who have recent dental X-rays should bring them for Dr. Lamas to review, depending on the age of the X-rays and the circumstances, he may decide to take new images.

Diagnosing Peri-Mucositis and Peri-Implantitis

Correctly diagnosing the severity of this disease is the basis for determining which treatment course will be effective; therefore, prior to starting therapy, Dr. William P. Lamas performs a meticulous periodontal examination, which includes evaluating the depth of the patient’s gum pockets.

Treating Peri-Mucositis at Lamas Dental Specialists in Miami

When a patient has peri-mucositis, repair is usually not required. However, if this disease is not addressed swiftly, it could cause the artificial root to become loose and fail.

Tartar and Plaque Removal

Conventional treatment involves removing the tartar and plaque that has formed on the exposed areas of the affected implants using manual instruments. These instruments may include: scalers, plastic curettes and an ultrasonic debridement device. Once the source of the inflammation is removed, the soft tissue will heal. Healing time typically only takes a few weeks.

Antibacterial Mouthwash and/or Antibiotics

Once the cleaning is complete, Dr. Lamas may provide the patient with an antibacterial mouthwash (0.2% chlorhexidine digluconate) to use. This mouthwash helps keep the mouth disinfected as it heals. In addition, antibiotics may be prescribed to help destroy any remaining harmful bacteria. Generally, repair is not required once the peri-mucositis is addressed.

Treating Peri-Implantitis

Since peri-implantitis sets in at a deeper level than peri-mucositis, removing this advanced form of the infection will most likely require that the patient receive local anesthesia.

Laser Therapy and Mechanical Debridement

The most difficult issue that dental professionals experience when decontaminating an artificial root is the honeycomb-like cells on its surface. This roughened surface is beneficial as it is meant to promote fast, solid integration with the jawbone; however, if peri-implantitis develops, this honeycomb design is troublesome in that it provides the bacteria numerous places to hide.

Laser therapy in conjunction with mechanical debridement can be used to reduce inflammation. However, if the non-surgical approaches to treating the second-stage of this infection are not successful, Dr. William P. Lamas will discuss his recommendations for surgical intervention.

Surgical Intervention for Peri-Implantitis in Miami

Patients who are having surgery with Dr. Lamas at his office in Miami may choose to have local anesthesia (remain awake throughout the procedure), IV sedation (i.e., twilight sedation) or nitrous oxide (i.e., laughing gas). Those patients who choose to have IV sedation must bring a licensed driver with them on the day of their procedure. For the safety of his patients, Dr. William P. Lamas does not permit his patients to use public transportation, taxi services or ridesharing services (e.g., Lyft and Uber, etc.) following IV sedation.

Surgically Treating Peri-Implantitis: The Procedure

1. Anesthesia is administered.
2. Once the patient is comfortable, Dr. Lamas will carefully create a flap by excising the gingiva, exposing the infected area.
3. He will remove the infected portions of gum as well as decontaminate the artificial root using a variety of surgical techniques and innovative dental equipment. As an experienced specialist, Dr. William P. Lamas has performed these techniques and knows how to decontaminate a dental implant without destroying its surface.
4. If excessive bone loss is present, bone grafting will be required to provide adequate support for the artificial root. After Dr. Lamas places the bone graft around the artificial root, he may decide to leave the it buried until the healing process is complete.
5. Once several months have passed and healing is complete, Dr. William P. Lamas will affix the dental prosthesis to the artificial root at his office in Miami.

Treating This Infection During Pregnancy

Since treating this inflammatory process involves taking X-rays and using antibacterial agents, choosing an experienced periodontist is vital. As a top periodontist and dental implant specialist in South Florida, Dr. William P. Lamas has treated pregnant and nursing women who have had both stages of this infection. He takes the time to formulate each mother a safe and effective treatment plan, always keeping her baby in mind.

Are Some Patients at an Increased Risk of Developing This Inflammatory Process?

Yes, patients who are at an increased risk of developing this infection include individuals who have:

  • A systemic condition

    – conditions like osteoporosis, diabetes, nutrition deficiency, compromised immune systems (due to HIV or cancer treatments, etc.) or genetic factors can play a role in the development of peri-implantitis, a receding jawbone and artificial root failure. Individuals with dental implants who have any of these conditions should practice good oral hygiene and visit their Dr. Lamas on a regular basis for check-ups.

  • Previous instances of periodontal disease

    – individuals who have previously had periodontal disease resulting in tooth loss are at a higher risk of developing peri-implant mucositis due a bacterial infection.

  • An inadequate blood supply

    – if blood does not rush to the surgical area, clot formation will be slow; thus, the healing process itself will be sluggish. Poor blood supply may be caused by an autoimmune disease, a clot elsewhere within the body or some type of blood disease.

  • An autoimmune disease

    – autoimmune diseases (e.g., Lupus, Rheumatoid Arthritis, Type 1 Diabetes, Multiple Sclerosis, etc.) are illnesses that cause the body’s immune system to attack and damage its own tissues. Unfortunately, individuals who have an autoimmune disease are at a higher risk for experiencing artificial root rejection.

Other Reasons for Dental Implant Failure

While infection is the main reason for failure, there are other issues that can lead to the need for repair in Miami:

  • Mechanical damages

    – if the artificial root becomes damaged during an incident that causes an injury to the teeth and/or mouth, the implant may fail.

  • Bruxism

    – this is the term used when referring to the repetitive grinding or clenching of the teeth. Bruxism frequently occurs subconsciously while an individual is concentrating, exercising, feeling stressed and/or anxious. Furthermore, this condition commonly occurs while an individual is sleeping. However, individuals who have sleep bruxism can help protect their teeth by using a mouth guard.

  • Lack of bone

    – if a patient does not have a sufficient amount of bone to support a dental implant, bacteria may enter, resulting in an infection. When performing the patient’s repair, Dr. Lamas may need to perform a bone graft and replace the artificial root.

  • Radiation therapy

    – if an individual undergoes radiation therapy for cancer in the region of the head and/ or neck, the risk of the artificial root failing increases. This is especially true if the individual is being treated for mouth cancer.

  • Certain medications

    – there are some medications that can hinder the osseointegration process, eventually causing the implant to loosen and require repair. For this reason, it is essential that patients are candid with Dr. Lamas and his staff about the medications they currently take as well as previous medications.

  • Poor health

    – the artificial root is less likely to integrate with the jawbone when an individual is in poor health.

  • Tobacco use

    – whether an individual smokes or chews tobacco is irrelevant, these products cause inflammation in the gums. This inflammation causes the arteries to contract, leading to reduced oxygen and fewer white blood cells. Since white blood cells are necessary to fight infection, the likelihood of developing an infection increases. The Journal of International Society of Preventive & Community Dentistry states that implant failure rates for individuals who smoke range from 6.5 percent to 20 percent.

The repair procedure Dr. Lamas performs will depend on the part of the implant that has failed. For example, if the crown has come loose and fallen off, he will just need to reattach the crown with cement. Should the dental prosthesis just sustain damage, Dr. William P. Lamas may be able to fix it while it remains attached to the artificial root. However, if the crown has fallen all the way off and sustained damage, a new crown may need to be created and then attached via cement.

Surgically Addressing Artificial Root Failure in Miami

1. First, the patient will receive anesthesia in the form of local anesthesia, IV sedation or nitrous oxide.
2. The failing artificial root is removed.
3. After removing the artificial root, Dr. William P. Lamas cleans the area.
4. Dr. Lamas can examine the jawbone: If it appears weak and thin, a bone graft will be performed.
5. If lack of jawbone density is what caused the failure, a bone graft will improve the density and give the artificial root a stable base. However, the permanent prosthesis will not be placed until the bone graft has completely healed.
6. Once several months have passed, the next step of the repair process can begin: Dr. Lamas will schedule an appointment for the patient to have his or her new artificial root and dental prosthesis placed.

Recovering After Dental Implant Repair in Miami

The symptoms a patient experiences after a repair procedure at Lamas Dental Specialists in Miami may include inflammation, soreness and discomfort.

Soreness and swelling can be addressed with an ice pack. An ice pack can be used for 10 to 15 minutes every hour on the areas of the face that are swollen. Ice should always be wrapped in some type of towel to protect the skin. Also, patients can take over-the-counter pain medications (i.e., ibuprofen) to relieve pain and reduce inflammation. Furthermore, consuming soft, cool foods can also help reduce swelling.

A patient who also undergoes a bone graft procedure should not apply pressure to the areas that were treated.

Follow-Up Appointment at Lamas Dental Specialists in Miami

During the follow-up appointment, Dr. Lamas will examine the patient’s mouth to ensure it is healing nicely. He will also discuss any continued food restrictions.

Risks Associated with Dental Implant Repair

As with any surgical procedure, there are potential risks that need to be taken into consideration:

  • Nerve and tissue damage

    – while rare, if nerve damage occurs, tingling, numbness or pain may be present in the chin, tongue, cheek, gums or lips. This damage may be temporary or permanent. Repair may require removing the artificial root altogether. Typically, nerve and tissue damage occur when any type of dental implant procedure is performed by an inexperienced dentist.

  • Sinus problems

    – when replacing teeth on the upper arch, the sinuses may be affected. Insufficient bone density in the back upper jaw requires special consideration when performing a dental implant procedure. A sinus augmentation can be performed in which Dr. William P. Lamas creates better support for the artificial root. Choosing an experienced surgeon to perform this procedure is essential because if the root enters into the sinus cavity, pain, inflammation and infection may result.

  • Allergic reaction

    – the most commonly used artificial roots consist of titanium alloy and, while extremely rare, patients can have an allergic reaction to this metal. Allergy symptoms may include inflammation, loss of taste, oral dryness, a tingling or burning sensation and/or chronic fatigue syndrome. The good news is that Dr. Lamas can replace these with the metal-free Zirconium artificial roots that are now available.

  • Failure of the implant

    – although the artificial roots used to support dental prostheses following tooth loss consist of Zirconium or titanium alloy, they can bend or even break; however, failure of the artificial root itself rare.

  • Under-Engineered procedure

    – this term refers to a procedure in which the dentist uses too few artificial roots to support the dental prosthesis being used, which leads to excess stress on the artificial roots and potential failure. An under-engineered procedure usually results when a dentist lacks the knowledge as to how many artificial roots are necessary to ensure a secure foundation for each type of dental prosthesis (i.e., crown, bridge, denture).

When One Implant Fails, Will They All Fail?

With the success rate of implants being so high, the likelihood of an additional artificial root failing is small. However, if a trauma of some kind led to the current failure, Dr. William P. Lamas will examine all of the patient’s teeth to make sure they remain intact.

If Maintained Well, Dental Implants Offer Patients a Long-Term Solution

Many times, when a patient needs dental implant repair, the problem is minor and Dr. William P. Lamas can correct it quite easily. Moreover, by seeking treatment right away, the likelihood of needing costly repairs decreases. Therefore, if you notice changes in the way your teeth feel, contact our office in Miami today at 305.440.4114. Each dental professional and staff member at Lamas Dental Specialists is dedicated to providing you with the high-quality, individualized care that you deserve.

 

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