If you lost one tooth, multiple teeth, or even the full arch, dental implants would be the first treatment option. So, dental implants have gained high popularity due to their high success rate. Recent technologies have also made it easier for specialists to do dental implant surgeries accurately.
Although dental implants are considered one of the best treatment options in several cases, they require advanced skills by the entire dental team so as to avoid the complications that might occur.
There are some patient-related complications that might occur during the implant surgery that might be serious in many cases.
Although pain is not common in many cases, it may be present due to trauma to soft tissue after surgery.
If pain persists after implant placement, several factors should be kept under consideration to be aware of the pain origin. Several causes can lead to pain, such as inflammation, nerve involvement, and thermal trauma.
Pain can also arise later due to peri-implant infection or excessive pressure from the prosthesis. For example, the overdenture can put excessive pressure on the implant, so it should be managed by the prosthodontist.
Pain arising immediately after the surgery is managed by mild analgesics, which could worsen the situation.
If the pain is still present, further investigations are required to be aware of the origin. In some cases, the implant can be removed. Inflammation and discomfort could be managed through the use of a hot saline mouth path.
Paraesthesia means loss of sensation in an area due to trauma or injury to a specific nerve.
So, it might occur as a complication of nerve involvement in the implant site. It usually subsides if mechanical damage to the neurovascular bundle has not occurred.
This damage is expected if paraesthesia stays for a long time. Paraesthesia is common in the lower jaw following extensive surgery in this region.
Before surgery, careful radiographic assessments should be performed, and careful surgical techniques should be used in these areas.
Developing infection after implant surgery is rare because the surgery procedure is done using careful sterile techniques.
Several studies have shown that the use of prophylactic antibiotics can reduce the problems associated with early implant failure.
Infection is mainly managed according to the symptoms that are present. Several causes can lead to infection, including the following:
- Poor oral hygiene
Poor oral hygiene is a contraindication for implant surgery, as it may lead to dental implant failure.
Plaque and calculus around the abutments can make bacterial spread to the implant much easier, which in turn can lead to the failure of the whole procedure.
- Impaction of a foreign body between the soft tissue and the abutment
Maintaining good oral hygiene, continuous irrigation with chlorhexidine solutions when necessary, and removal of calculus and plaque around the abutment using plastic scalers will significantly improve the clinical situation, preventing possible opportunities for infection.
This is a condition that is characterized by inflammation of the soft tissue around the implant, excluding the peri-implant bone. This condition includes
The soft tissue color around the implant is changed to red instead of being pink. The inflammation is mainly due to the accumulation of plaque and calculus around the abutment and implant components.
This can be managed through regular scaling and maintaining good oral hygiene.
Swelling is also considered a sign of mucositis, which comes with inflammation. Swelling always subsides after maintaining good oral hygiene and doing regular periodontal therapy.
- Increased probing depth
Probing depth measurements are considered one of the methods that dentists use to estimate the health of gingiva and adjacent soft tissues.
If the probing depth is increased, this ensures the presence of periodontal pockets, which are suitable for bacteria to invade the soft tissue, thus leading to the failure of the whole procedure.
Management of peri-implant mucositis
Good oral hygiene is considered one of the most important factors in the success of the dental implant procedure. Correct brushing and regular flossing are the best ways to maintain good oral hygiene.
Treatment of periodontal pockets using regular scaling and chlorohexidine solutions is a must to maintain good oral hygiene, which in turn can lead to the success of the overall procedure.
Peri-implantitis is a more severe condition that is characterized by loss of the bone around the implant (bone-implant contact).
This occurs due to infection of the connective tissue surrounding the implant. This condition can be diagnosed by clinical examination methods including probing depth measurements in the peri-implant sulcus region.
The peri-implant sulcus region is deepened due to the loss of bone in this area, which is strong evidence of peri-implantitis. It can also be diagnosed by radiographs as bone loss around the implant will be visible.
Causes of peri-implantitis
There are several causes that can lead to peri-implantitis, which might be systemic or local.
- Systemic factors
Smoking is considered one of the most important causes that might lead to implant failure. It delays the healing process, and it can also lead to severe inflammation of the soft tissue around the implant, which might lead to implant failure. So, smokers are contraindicated for dental implants.
There are some chronic diseases that may affect the procedure of dental implants. Patients suffering from uncontrolled diabetes might have delayed healing and poor quality of bone.
This may have an impact on the whole procedure, thus leading to its failure. So, patients suffering from uncontrolled diabetes are contraindicated for dental implants.
- Local factors
Local predisposing factors include
Poor Plaque Control
Poor oral hygiene can lead to an accumulation of plaque and calculus over the abutment of the implant, which can lead to implant failure.
There are many factors that can cause mechanical irritation, such as improper placement of the abutment and the presence of calculus around the abutment, which can increase the degree of inflammation.
Plaque and calculus can promote bacterial invasion into the peri-implant sulcus. Periodontal diseases can also promote bacterial invasion and spread into the soft tissue, which leads to failure of dental implant procedures.
Management of peri-implantitis
Peri-implantitis can be controlled in the early stages if there is no significant tissue loss by removal of mechanical and bacterial causes.
Many cases require periodontal surgery by exposing the bony crest and using cleansing agents to clean the implant and abutment
Hemorrhage means excessive bleeding during surgery. This can occur due to the involvement of a blood vessel while drilling to place the implant or due to perforation of the bone during the procedure.
The soft tissue can also be traumatized, leading to excessive bleeding. So, there are many reasons that can lead to hemorrhage during surgery, which can be life-threatening for patients suffering from bleeding disorders.
The management of such a complication requires advanced skills by the surgeon. This can also be avoided through good radiographic assessments before the surgery.
There are also some complications which are related to dental implants
- Implant mobility
Implant mobility is considered one of the most common complications that might occur due to failure of osteointegration interface formation between the implant body and adjacent bone.
This can be due to the primary stability failure of the implant. Several factors can affect primary stability, such as: anatomy and density of bone, or the implant site has been prepared without care so that it becomes oversized.
Such problems can be avoided by doing proper radiographic assessments, using the proper surgeon’s guide, and taking care when preparing the implant site. It can be managed by using tapered implants or oversized implants.
- Implant location
Placing the implants in the proper locations is a must because it directly affects the prosthesis.
So, implant location should be planned with the prosthodontist before the surgery to avoid problems that might occur during the prosthetic phase.
- Problems with placing screws
Screws are considered one of the most important components of an implant. These problems can arise due to misalignment of the screw or damage to the screw threads in the implant body.
These cases are rare due to recent technologies applied to dental implant components and designs.
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