Penam Periodontics - Evidence based Personalized Periodontics

Implant Complications.

Dental implants can have two basic types of complications;

1. Immediate or those that occur as result of surgery and its aftermath;
2. Long term or those that occur with the passing of time or over the years the implants are in use.

Immediate complications can be:

• Haemorrhage or bleeding;
• Neurosensory disturbances. Trauma to the nerves during surgery;
• Injury to adjacent teeth;
• Surgical flap dehiscence and exposure of graft material or barrier membrane;
• Failure to gain primary stability of the implant;
• Failure to correctly place the implant;
• Bisphosphonate-related osteonecrosis;
• Complications associated with maxillary sinus lift;
• Sinus floor membrane perforation;
• Haemorrhage;
• Loss of the implant or graft materials into the maxillary sinus;
• Postoperative maxillary sinusitis.

It is not the context of this web presentation to discuss these in any detail. We will discuss them with you.

Immediate implant placement risks

Immediate implants whilst they offer an immediate potential solution to your smile, have greater risks of complications at time of surgery. It is more difficult to place the implant accurately due to the bony architecture; greater risk of not being able to obtain good initial stability and to provide a tissue approximation to the implant.

The long term complications are grouped into two basic subgroups:

1. Biological; or
2. Mechanical.

The biological complications may consist of:

1. Peri-implantitis (infection around the implant – like periodontitis);
2. Mucositis (like gingivitis);
3. Bone loss around the implant (usually associated with 1.);
4. Loss of the implant due to 1 and 3;
5. Failure to follow the maintenance protocols.

Calculate your biological risk of complications/failure. This may assist you in understanding the issues.

The mechanical complications may consist of:

1. Fracture of the implant;
2. Fracture of the crown, abutment or their components;
3. Screw loosening;

 We as periodontists are principally concerned with the biological complications and the correct placement of the implants at surgery to minimize the mechanical complications. We will select implant types that are appropriate for your case and will consider all these possibilities when we plan the case with your dentist or other specialists.

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