why some dental implants fail

The estimated reading time for this post is 6 minutes

Dentadental implant failure diagraml implants are anchors to your jaw that support your bridges, dentures, or crowns, helping them function just like natural teeth. After healing, dental implants can maintain the integrity/bone volume of your jaw and restore your bite.

Though they come with many benefits, sometimes dental implants fail. It is important to note that dental implant failure is not due to the body rejecting it. They do not create antibody-antigen type responses like organ transplants.

Failure occurs for reasons that either stem from local or systemic (general health) factors, the surgery itself or your post-op care.

What Are the Overall Reasons for Dental Implant Failure?

Implant failure can be divided into two categories. Early failure describes the situation when an implant is placed but fails to integrate (become solidly embedded into the bone). Late or long-term failure describes the situation where an implant has integrated solidly, but after many months or years, there is bone loss around the implant.

The causes of both of these failures are very different. In both cases, if we follow certain protocols in diagnosis, treatment planning, surgical protocol, and prosthetics the risk of these failures is still extremely low. Ten-year survival rates of integrated implants are still over 95%.

Nevertheless, that means very little if you happen to fall into the unfortunate 5%. So if that happens to be you, I have written this to try to help explain some of the things that may have contributed to your current problem.

Sometimes the patient may not have taken care of the implants well, allowing bacteria to grow and cause infections. Bruxism or improper bites cause undue strain and pressure on the implants, triggering failure. There are also chances of the surgery being done improperly, resulting in infections.

implant failure chronic health conditionsChronic health conditions like autoimmune disorders, diabetes, or osteoporosis also play roles in implant failure. Certain medications can also put patients more at risk for losing their implants.

Although there are many factors that contribute to dental implant failure, the good news is that a majority of failures can be salvaged with early intervention and proper medical attention. There are two types of failure: early failure and late failure.

Early Dental Implant Failure

Early failure is any dental implant failure that occurs within the first 3-4 months after the procedure.

Surgical protocol is important for any type of surgery. I am an instructor for a 10-month introductory course on dental implants and a large percentage of that teaching is about surgical protocol, from diagnosis to treatment planning to surgical execution.

So it is impractical to write and describe all the aspects of surgical protocol in this blog. Nevertheless, these are a few basic principles:

  • Make sure everything is sterile during surgery. This will avoid any chance of infections that can lead to implant failure. Though infection is a rare cause of failure in early failure, it still should be considered a factor and something to be avoided at all costs.
  • Ensure the patient’s bone is not overheated. Too much heat will cause cell and tissue death (necrosis), resulting in lesions and pain.
  • Use the correct surgical flap design based on the nature of the tissue surrounding the dental implants.
  • Make sure the implant is stable initially. This basic precaution during the surgery is the foundation of the procedure’s success. If there is movement of the implant during the healing phase, it will not properly integrate.
  • Place the implant on a site with adequate bone volume. Some patients may not have enough bone to support a dental implant, so if an implant is inserted anyway, the bone will not be able to integrate with it, resulting in early failure.

I would expect that any dentist placing implants would be well aware of the above protocols as well as much more.

Nevertheless, even the most experienced dentist/surgeon will have some implants that fail to heal properly. Just because this has happened, do not immediately assume they have done something incorrectly. (I would say that any dentist who says they have never had an implant fail to integrate has not placed many implants!).

dental implant integration with jawSometimes, there are implants that won’t integrate with your jaw in spite of everything being done correctly.

This can be due to a few factors:

  • There is a poor blood supply to the dental implant area, resulting in insufficient healing.
  • Certain medications like bisphosphonates (used to treat osteoporosis) can increase the risk of early implant failure (as well as late implant failure).
  • Poor health. An unhealthy body will be less likely to integrate with a dental implant as it is not functioning as well as a healthy body.
  • If there are existing infections adjacent to the implant site (sometimes these can be hidden as in a previous root canal).
  • Sometimes the implant moves or shifts during the healing phase.
  • The implants are not given enough time to integrate, attaching the teeth too soon before they are able to bear the burden.

Having a qualified and experienced implant dentist eliminates many of these factors. Simply having the surgery done correctly decreases the risk of early failure from an incorrect procedure.

Patients also have the responsibility of being completely transparent with their doctor about all medications they take and their current health condition. With both doctor and patient being well-informed and working together, the chances of success are high.

Surgery for dental implants

Characteristics of Late Dental Implant Failure

Late failure happens long after the dental implants have been established and functioning. This failure occurs between 1-10 years after your new teeth are placed.

There are a few common reasons why implants can fail at this stage:

  • The procedure was “under-engineered”. There are too few implants supporting the teeth, which caused excessive stress to the implants.
  • Clenching and grinding teeth. If the patient has bruxism and they do not proactively control this issue with behavioral modifications and a night guard, the dental implants can also endure too much pressure and fail.
  • Poor oral hygiene. This leads to gum disease and other infections.
  • Lack of gum tissue. This particularly pertains to the thick attached gum tissue that provides the seal around the implants.
    Chronic metabolic diseases like diabetes can make one at a higher risk of late failure.
  • Head and neck radiation. Irradiated patients have been reported in studies to have an increased risk of dental implant failure.
  • Lack of bone to support the implant. When excessive bone is lost, bacteria can invade and settle on the implant’s rough surface, becoming a petri dish for bacteria. The location of bacteria is difficult for your body to purge and often this kind of infection will result in the removal of the implant if left unchecked or untreated.
  • Food impaction around the implant. This can break down the seal around the implant, causing discomfort, pain, and infection.
  • Bacterial infections. If bacteria is getting under the gum and causing an infection, you will need to insert a tiny ligament in the gum tissue to seal this area around your teeth and implants can help prevent this problem from persisting. There are especially fewer ligaments around implants compared to natural teeth, so this procedure can help prevent future infections.

If you have more questions about why dental implants can fail, contact us.

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 About Dr. Balogh

Dr. Balogh - Expert in Cosmetic Dentistry and Dental ImplantsDr. Peter Balogh (B Sc., DDS) is a cosmetic dentist at the Vancouver Centre for Cosmetic Implant Dentistry in Burnaby, BC. He is a Fellow at the American Academy of Implant Dentistry and International Congress of Oral Implantologists. Dr. Balogh has been a practicing family dentist for over 25 years and has a special focus in cosmetic dentistry and implant dentistry. In the past, he was a surgical instructor at the University of Boston School of Dental Medicine.

14 thoughts on “Why Some Dental Implants Fail

  1. if you have osteoporosis can you still get implants or will they fail they tell me I am a minus 2 when I had bone scan done but don’t have any broken bones at least not yet I been told they will fail

    Reply
    • Hello Kim

      Thank you for your comment.

      Generally, osteoporosis affects the hips and longer bones before it affects the jaws. Having implants will place stress on the bones and stimulate them to be maintained in volume and density.

      A bone density of -2.5 is just at the borderline of being diagnosed with osteoporosis. If your BMD score was significantly less than that, I might have some reservations or would need to be more cautious. The implants would have to be assessed individually and on a per-site basis.

      I have treated many patients with osteoporosis and have not had any issues. We sometimes have to modify our treatment and healing time takes slightly longer but it has not been a major issue.

      A potentially long-term problem for osteoporosis patients with implants and even dentures is the complications with the medications (Bisphosphonates) that are given to patients with osteoporosis.

      I hope that answered your question.

      Sincerley,

      Dr Balogh

      Reply
    • Hello, Mitchell

      Thank you for your comment.

      Two weeks following surgery you might have some minor discomfort but it should be significantly better than the first week. You should be noticing an improvement every couple of days. Check with your dentist/surgeon to make sure there is no infection, pressure on the site or something else going on.

      I hope this helped to answer your comment.

      Sincerely,

      Dr Balogh

      Reply
  2. I had a implant fail 3 times. First time the bone graft was coming out after several days and the dentist removed the implant. Second time, same location, the implant fell out. Third time after being in for several weeks exray showed implant to be crooked and it was removed. So # 7 is an empty space and I am out $ 3000. 00. I do have 3 other implants that I have had for over a year or two. I also had a blade implant for 30 yrs.

    Reply
    • Hello David,

      Thank you for your comment.

      It is difficult to determine why you had issues in this area. Anytime something does not turn out as expected I always look back at my notes and the procedure to see if there was anything that I had done that was different.

      If not then I look at the area. I ask myself, is there something going on with the adjacent teeth? Some unusual history of infection in the surgical site? Something medically that was not noted or missed?

      Sometimes implants do fail, but if we can make adjustments in technique or protocol then usually the next one works just fine. But success comes with understanding what caused the failure in the first place.

      It seems from your description that all three attempts failed for slightly different reasons. I would not give up, especially if the bone in the area is still in good condition; but if it were me I would have a discussion with my dentist.

      Be sure that your dentist thoroughly understood the reasons for the past failures and ask if he feels confident in moving forward. Or ask if alternative solutions should be looked into.

      Reply
  3. Dr. I just had implants uncovered today they had been in for three months of the four that were put in the two right beneath my nose ffailed what can I do? The surgeon Dr o Neil is a stately old gent and well thought of. He did my bottom 4 and one fell out. This was for a 4 on one procedure. He saved me a bundle by being able to spare me the grafting. As it was I spent 8k. I am 66 and on Methadone. He is willing to redo it but I don’t think I can stand the pain. As it was I only used locals and 10 Oxys for post. Will he have to tap a new hole? Won’t that create a Swiss cheese out of my jaw? He was shocked. He said one in 20 fails but sine I lost 50% I feel like I should cut my losses and see what can be done with the two good ones. The procedure was in aug 2017. It is Halloween. Did the lack of bone graft cause it? The ones behind the incisor area were fine. I go back in 2 weeks advise please

    Reply
    • Hello Walt,

      Thank you for your comment.

      It is difficult to say why those implants failed without knowing more about the site and the surgical steps and protocol. The bone in the upper jaw is not as dense as the lower and being in the front the bone is often thinner so there may be several reasons why they failed.

      You may need more grafting if it was not done at the time the implants were removed. Just because these two failed does not mean you cannot have implants in that site, however, it would be important for your dentist to understand why they failed to avoid a repeat occurrence.

      You may choose to stay with only two implants but the type of teeth and the amount of retention will have to be modified from what was planned using four implants.

      I hope that helped to answer your question.

      Sincerely,

      Dr. Peter Balogh

      Reply
  4. Hi Dr Balogh,

    I have just been to my dentist to check the implant he put in a few months ago to tell me it did not take, so I have the option to revisit a few months time and he hopes the second attempt will be a success. I am reluctant and now I am thinking of a bridge, as the the 2 teeth either side I am putting crowns on them anyway. I am extremely disappointed but I want to make sure the teeth look right as its my front tooth. Any advice would be super ! thanks, Trish

    Reply
    • Hello Trish,

      Thank you for your inquiry.

      There are times we place an implant and it does not take, however it doesn’t mean it will fail the second time or that an implant is not possible. It’s most important for your dentist to understand what likely caused the first failure so as to avoid another failure, and to ensure the bone is healthy and of adequate volume for the second attempt.

      Even if you are crowning the adjacent teeth, if it were my own teeth I would not give up as in the long term having an implant will give you fewer potential problems than a traditional bridge.

      I hope this helped to answer your question.

      Sincerely,

      Dr. Peter Balogh

      Reply
  5. I had 4 dental implants with overdenture on upper. After 5 years, I had a sudden onset tenderness at one of the posts. When the periodontist took off the overdenture, one of the posts fell out with a second so loose it came out easily. At that time it was found the upper ridge has deteriorated and was gone. Prior to this time I had been seeing my dentist and periodontist alternately every three months during the 5 years without any problems or concerns. A replacement temporary upper denture was made. Due to flat platete, I am unable to keep suction to keep the denture in. I am unable to eat, chew, or maintain. The dentures in my mouth with gagging after time. I am negative for osteoporosis per dexascan. I am looking for possible solution to my problem. Is rim
    augmentation a viable solution with replacement of implants.

    Reply
    • Hello Diane,

      Thank you for your comment.

      Certainly, the bone can be rebuilt and another implant put in place. A very important point is for your dentist to try to understand why the implant failed in the first place to avoid a repeat occurrence or a similar failure on one of the other implants.

      Most commonly it is overloading of one of the implants or an inability to keep the area clean, although there are other factors/possibilities.

      I hope that helped to answer your question.

      Sincerely,

      Dr. Peter Balogh

      Reply
  6. Hi

    I had 7 implants done 5 months ago , 6 at the top and one at the bottom .
    The bottom one has healed and i now have a tooth in there.

    The top implants are ready except one , i had to wait another month as the one had not healed yet , i went back today and it has failed and he took it out. I am now going to have it re done in 3 weeks in the same place. Will it heal being put back in the same place ? the other 5 are ready and have healed but now i have to wait another 3 to 6 months after the failed one has been re done to have my bridge which is upsetting . Is it correct to re do it in the same place and can trying again work ?

    Reply
    • Hello Tracey,

      Thank you for your comment.

      Yes, there is no problem in placing the implant back into the same location, just as long as there is adequate bone and no infection in the area.

      In fact, in a few cases, I have found an implant “failed” and after removing it found the bone was healthy, but soft tissue grew all around the implant (instead of bone).

      The implant was removed, the soft tissue thoroughly cleaned out and a new implant put in its place at the very same appointment. Your dentist is being cautious by letting it heal for a few weeks, but otherwise, the protocol is certainly correct and OK.

      I hope that helped to answer your question.

      Sincerely,

      Dr. Peter Balogh

      Reply

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