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Preventing Dental Implant Failure

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I had a couple of friends who had dental implants done. One of them was successful and the other was a failure. The one who had the good case had a CT scan. The other didn’t. Is a CT scan the trick to a successful procedure? The other question I have is the type of implant. A dentist I am looking at uses Southern Venturi. Neither of my friend’s dentists used that. Is this a good implant?

Carlton

Dear Carlton,

An assortment of titanium and zirconia dental implants.

I do love it when patients do some research. Like you, they usually have good questions when they come to their consultation appointment. Let’s start with the CT scan. I would consider this a non-negotiable. It isn’t a guarantee of a successful procedure, but greatly improves the chances. The reason for this is the nature of dental implants. It is a 3-Dimensional procedure. Because of that it requires 3-Dimensional scans. Doing this ensures that your dentist knows if you have sufficient bone support. It is also a way to make sure that your dentist will not accidentally bump into a nerve or perforate your sinus cavity during to procedure.

As for the type of dental implant fixture, I am not familiar with Southern Venturi. It is important that these are manufactured to exact standards. There are some fixtures that the best implant dentists tend to favor. These are:

  • Straumann
  • Nobel Biocare
  • 3i
  • BioHorizons
  • Zimmer
  • Astrotech

I’d like to also add that the most important part of the dental implant procedure is choosing the right dentist. This is an advanced procedure. It is also the leading cause of dental malpractice suits. Dental school training alone will not be enough. You will want to make sure you go to a dentist who invested in post-doctoral training in dental implants. You also want a dentist with a high success rate. I would expect it to be a minimum of 95%. You won’t find one that will be 100% because even if a dentist does everything right, there can still be some case failures. Sometimes, the human body just rejects a treatment.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.
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A Case of Dental Incompetence

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I had a dental implant placed. A few weeks after it was finished I noticed it felt a bit loose. I went back to the dentist. He felt that it was just the crown that was loose and all it needed was to be re-bonded on. That sounded like good news to me but he started having trouble getting it off. Then, he tried with this special tool. When he pulled on the crown, the entire dental implant came out. Is this normal? Is there a way to fix this?

Danny

Dear Danny,

metal and zirconia dental

I would love to hear how your dentist explained that! No, that is not normal. It was obviously not your dental crown that was loose, but the dental implant the whole time. When the crown did come off when he first tried, he HAD to know that it was really the dental implant that was loose. The amount of incompetence it would take to not realize that is almost unfathomable. Fixing a loose crown is simple. Fixing a loose implant is not. The thing to figure out is why was the dental implant loose to begin with.

Some Causes of a Loose Dental Implant

I don’t know the exact timeline of when your dental crown was placed, but one cause of a loose implant is from what is known as premature loading. This is when the dental crown is placed before the bone has had time to integrate with the dental implant fixture.

Another reason would be an infection. There would usually be pain and/or fever with that. You did not mention either so I tend to think that is not the problem.

Fixing this issue will not be as simple as just replacing it with another dental implant. Instead, you will need some bone grafting done first in order to build up the bone that was lost when the implant was pulled out. After that, then you have to start over with the implant procedure.

In your place, I would demand that your dentist pays to have this repaired, including the bone grafting. You should be the one to pick the dentist to do the repairs. Make sure you get an expert implant dentist to do the work. Take a peek at Dr. Marion’s bio to get an idea of the type of post-doctoral training and expertise you want in an implant dentist.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

Maryland Bridge Before a Dental Implant

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My preteen has a congenitally missing tooth. She’s getting to the age where it really bothers her. We’ve finished orthodontics to move her teeth in a way that makes space for the missing tooth. Our long term plan is to get her a dental implant, but know she is too young for that now. Our dentist suggested that we get a Maryland Bridge as a temporary replacement so that her teeth do not shift while we wait on the dental implant. She used non-metal wings for them, which I was grateful for, but the next day the bridge fell out. Our dentist then ordered some new, stronger cement, but again, it fell out the day after she put them on. Now, our dentist is wanting to use metal wings. I do have some questions though, given recent experience. Please advice me on this.

1. Will the metal bond well enough to last the six years we need for her to get the dental implant?
2. Will the metal show through much? This is a visible tooth?
3. Will there be any cosmetic damage to the tooth when we remove the bridge?

Martha

Dear Martha,

illustration of a dental implant next to a tooth

First, I want to congratulate you on making such a great choice for your daughter’s tooth replacement. Dental implants are the best option and will not only give her a secure tooth, but will also preserve the bone in that area.

I can tell that your dentist means well and is trying her best. However, I believe she may be out of her depth here. It does not appear that she has technical knowledge and skill which she needs to do cosmetic bonding.

Images illustrating the placement and preparation for a Maryland BridgeEven with metal wings, I do believe she will end up having the same struggles. Bonding on a Maryland Bridge is not simply a matter of cementing the wings onto the tooth. It requires some tooth preparation as well, such as the notch you see in the image directly above, to help secure it. This notch removes tooth structure and will have to be filled in with dental bonding after the Bridge is removed.

Anything that makes a permanent change to the tooth does not sound to me like a temporary tooth replacement. What you want is something easily removable that will not require any structural changes to the adjacent teeth. I recommend you get a dental flipper instead. These are inexpensive and are super simple to remove when she is ready for her dental implant. In fact, your daughter could pop it in or out herself if she wanted to.

I am a bit concerned that your dentist may not be qualified to do the dental implant, which is a much more advanced procedure than what she is struggling with now. In your place, I would recommend that you find a dentist with significant post-doctoral training in dental implants. Look at Dr. Marion’s bio to get an idea of what type of training your dentist will need.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

 

Will Metal Show On Front Dental Implant?

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I was playing football with some friends and was not wearing a mouthguard (or a helmet). I already know that was stupid so don’t bother getting onto me about that. I would like to get a dental implant to replace the tooth. I am concerned, however, that the metal from the dental implant will show through in the gums because it is a front tooth. Is there anything I can do about that?

Carl

Dear Carl,

An assortment of titanium and zirconia dental implants.

While everyone’s body is different, most people have no problems with their dental implants showing through. Your dentist will run tests to check all the factors involved in whether you are a good candidate for dental implants. Make sure your dentist includes a CT scan in the diagnostics. Dental implants are a 3-dimensional procedure and it requires 3-dimensional imaging. This will help with more than just bone density and gum depth. It will also help your dentist avoid your nasal cavity as well as any nerves.

The key to a successful dental implant procedure is a skilled implant dentist. Unfortunately, there is not a recognized specialty in dental implants. If a dentist wants to develop that skill set, they need to get post-doctoral training. You will need a dentist who has invested in that training.

There are way too many dental implant horror stories from patients who underwent the procedure with an underqualified dentist. I do not want that to happen to you. My suggestion is that you look at Dr. Marion’s qualifications to get an idea of the type of dentist you need.

One other consideration. Generally, an oral surgeon will do the surgical part and then the dentist will do the restoration. However, it is very important that it is the dentist who determines the placement of the implant. Go to the dentist first, then the oral surgeon.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.