How Do You Diagnose a Failing Dental Implant?
Q: I am about to spend a ton of money on replacing all my missing teeth with dental implants. The internet info is overwhelming. How do you know if you have a failing implant?
A: Although I’m no Aztec when it comes in finding the meaning of numbers, I did a fun little bit of research when I received this letter. Follow me: (but not too close, I had angel hair with garlic and oil for lunch.)
A Google search for “dental implants” yields a result of 1,360,000 hits. A Google search for “dental implant failures” results in only 227,000 which is only 16% of the hits compared to plain old “dental implants”.
Here is the cool part. Sixteen percent COINCIDENTALLY, is the reported failure rate for a single dental implant based on the scientific research. This means the success rate for an implant is 86%. (No animals were harmed in my study other than a few dust mites under the space bar on my keyboard feeding on Ring Ding crumbs.)
Keep in mind that just because one implant fails, the entire case may not fail as many times we place extra implants to support full arches of permanent crowns or “snap-on” Over-Dentures, allowing us to remove an implant in the future.
There is no specialty of dental implantology, it is an “emphasis of practice” for those that have taken post graduate education after dental school during their entire career. Many dentists like myself perform the extractions, implant surgery, bone grafts as well as the final permanent teeth. Oral surgeons and periodontists will place your implants, but will not design or fabricate your final teeth.
Here is the “Quality of health Implant Scale” as reported by the late C.E. Misch DDS, the guru of implants: NOTE: He was not an oral surgeon or a periodontist. Almost all of these conditions below are caused by peri-implantitis, a lack of professional maintenance and personal oral hygiene by the patient, causing bone loss.
Group I, Successful implant: no pain, mobility, or exudate (puss), and less than 2 millimeters of bone loss seen on an X-ray.
Group II, Satisfactory survival: Same as above, but X-ray shows 2 to 4 millimeters of bone loss.
Group III, Compromised survival: Same as above, but X-ray shows more than 4 millimeters of bone and a periodontal pocket depth of more than 7 millimeters. This implant may not be salvageable.
Group IV, Failure: pain on chewing, mobility, X-ray shows bone loss of more than half the length of the implant, and uncontrolled exudate (puss).
In the next article, “Failing Dental Implants Part II” I explain what we do to treat each of these situations.
Dr. Mitchell Josephs practices Implant, Cosmetic and General Dentistry with an emphasis on implants, porcelain veneers, and complex crown and bridge treatment. He is on staff at JFK Medical Center and is a Faculty Advisory Board member at McGill University’s Faculty of Dentistry. He completed his residency at Manhattan’s Beth Israel Medical Center and Mt. Sinai Hospital.