Dentistry does not stand still, and today the loss of one or more teeth is not an insoluble problem. Modern technologies make it possible to restore lost dental units and their functions through implantation. However, implant placement is not the final result. The process of its engraftment in the oral cavity is important, which can sometimes occur with complications. It is important to understand in time that something is going wrong and take appropriate measures.
How long does an implant last?
One of the first questions that patients planning to implant ask is how long it takes for the implant to fully heal. The average period of its survival is determined by the place of installation: in the lower jaw, complete healing of tissues occurs within 2-4 months, and in the upper jaw - six months.
Such a difference in how long the installed implant takes root is associated with the physiological characteristics of the structure of the jaws. In large and strong mandibular bones, the process of blood supply proceeds better, plus they have a greater load when chewing. As for the maxillary bones, their proximity to the maxillary sinuses greatly complicates the implantation.
Other factors that affect how long an implant takes to heal include:
- initial state of the maxillofacial system;
- design model and quality of materials;
- specifications.
As for the unpleasant symptoms caused by the resulting injury to the soft and bone tissues, they should disappear after 3-7 days. The maximum allowable period is 2 weeks.
How to understand that the process is going wrong?
If there is a rejection of a dental implant, the signs of this process appear almost immediately, within a few days after the operation. However, you should not relax after installing a crown or even after the end of the recovery period. Regardless of whether rejection occurred immediately or after a long time, there are signs that help to understand that the process is proceeding with disturbances. The causes of adverse effects and complications of implantation at different times of their occurrence are various factors.
Signs of rejection
The implantation procedure is a surgical intervention that results in injury to nearby tissues, mucous membranes and, in some cases, crowns of neighboring teeth. As a result, after the operation, during the healing process, symptoms appear that are considered normal. These include:
- bleeding from a wound;
- swelling of the gum tissue;
- soreness of adjacent dental units.
However, sometimes designs do not take root. This does not happen often, but in such cases, the help of professionals is required. Rejection of a dental implant is evidenced by:
- severe sharp pain;
- redness and swelling of the gums;
- profuse and prolonged bleeding;
- the appearance of purulent discharge;
- mobility of the installed structure.
In case of rejection of implants, such symptoms do not go away for a week or more, and their severity does not decrease with time, but only increases. Against this background, the temperature may rise, chills and bad breath may appear. If you have these symptoms, you should not delay contacting your dentist.
Causes of Violation of Survival
Dental implant rejection occurs in only 1–2% of patients. Depending on the time of occurrence of the problem, three periods are distinguished:
- short-term - 3-6 months after installation;
- medium-term - up to 2 years;
- long-term - when the implant is rejected after 2-5 years of operation.
As for the reasons for the rejection of dental implants, they are largely determined by the period when the complication occurred. In the short term, the dentist is most often responsible for implant failure. A medical error is possible due to the inexperience of a specialist or due to careless operation and installation of a titanium pin.
The product itself, including the crown, can also become a source of the problem. Inexpensive and low-quality materials cause fibrosis of bone tissue and lead to loss of the structure. The presence of allergies is also one of the likely causes of rapid rejection.
Among the reasons for the rejection of the installed product in the medium term, it is worth noting:
- incorrect design selection;
- low-quality materials that oxidize over time;
- anatomical features of the structure of the jaw, such as malocclusion;
- jaw trauma leading to displacement of the product;
- exacerbation of chronic diseases, such as allergies.
Why did the implant fall out in the long term? In this situation, the patient himself is most often to blame. The reason may be elementary non-compliance with oral hygiene, bad habits, especially smoking, or failure to follow the recommendations of the dentist regarding the care of artificial teeth.
Re-implantation: indications and contraindications
In most cases, re-implantation is possible. It is allowed to implant the implant for the second time only 1-2 months after the removal of the non-engrafted structure. Sometimes before surgery, additional bone grafting and drug treatment may be required to restore injured tissues. It is also important to find out the cause of rejection in order to exclude its recurrence, whether it is a dentist's mistake, an allergy or improper care.
The main contraindication to re-implantation of the implant is a strong destruction of bone tissue. It occurs if the problem of rejection is not solved in a timely manner and the inflammatory process is not stopped.
If an implant falls out
An important point in preventing serious complications in the event of implant rejection is to take timely appropriate action. If the design suddenly fell out or the first suspicious signs appeared, you should immediately contact your dentist.
Based on additional diagnostics of the jaw condition, the doctor draws up a further plan. Most often, bone restoration is required. It is also necessary to carry out therapeutic measures that contribute to the restoration of the body's immune system. Only then can the issue of re-implantation be considered.
How to prevent implant rejection?
The probability of a normal course of implantation and engraftment of the product is very high, however, it is possible to initially reduce the risk of rejection of the structure to a minimum. For this you should:
- choose a highly qualified specialist and clinic where the procedure will be performed;
- do not save on materials, choosing a quality, well-proven product, time-tested;
- comply with all requirements for the care of implants and recommendations regarding oral hygiene;
- regularly visit the dentist's office for preventive examination;
- closely monitor the engraftment process and the subsequent condition of the implant and immediately consult a doctor at the first sign of a problem.
- What symptoms are usually accompanied by implant rejection and when exactly problems can begin;
- How long do implants take root and why are they sometimes rejected;
- What sensations are considered normal after a recent operation, and which are signs of dangerous inflammation in the area of the implant;
- What to do if inflammation has begun and whether re-implantation is possible after rejection of the implanted structure.
... And also some other interesting and practical nuances regarding the problem of implant rejection.
It should be understood that dental implantation is a rather complicated and to some extent traumatic procedure, the process of tissue healing after which does not always proceed smoothly: swelling, bleeding, pain due to injury to the gums and jawbone are possible. However, all these are normal consequences of surgical intervention, which disappear on their own after a few days.
But there are also complications that require surgical intervention by a doctor. And, perhaps, the most unpleasant of them is the rejection of a tooth implant. The first symptoms of this problem are, as a rule, acute pain, mobility of the structure, the appearance of an unpleasant odor, as well as redness and swelling of the mucosa near the outer part of the implant (abutment, plug).
Generally speaking, implant rejection is quite rare today, and patients do not need to pre-adjust to an unfavorable outcome of the operation. However, it is imperative to know the characteristic signs of incipient rejection, to understand what causes inflammation under the implant - it is always useful to be prepared for possible complications in theory in order to prevent their occurrence in practice.
How long do implants usually take to heal and when can they be rejected?
The average healing time of implants is about 2-4 months in the lower jaw and about six months in the upper jaw. This difference is explained by the fact that the bones of the lower jaw are better supplied with blood, they are generally larger and stronger, they have a higher chewing load. In addition, the nasal sinus is located above the bone tissue of the upper jaw, the proximity of which often introduces additional difficulties when installing implants.
Osseointegration (this is the medical term for the process of fusion of metal roots with the jawbone) begins immediately after the installation of structures. The terms of engraftment largely depend on the initial state of the jawbone, as well as on the quality of manufacture and the model of the implant itself.
At the same time, the method by which the implants were installed in the jaw does not play a special role. Regardless of whether the implants are loaded immediately (for example, with basal implantation), or only after complete fusion with the bone, in both cases, the healing time does not differ much.
According to statistics, if the rejection of implants does occur, then in most cases this is observed in the first days after their installation. In other words, if something went wrong, then the first symptoms of a complication, as a rule, do not take long.
However, the patient should not lose vigilance even after successful engraftment of the structure - inflammation after dental implantation with subsequent rejection of the implant can overtake even after several years of its active operation.
The photo below shows a relevant example (inflammation began 10 years after the implant was placed):
Below we will see what can be done to avoid this unfavorable outcome. However, before that, let's talk about what sensations are considered normal after dental implantation, and which should be taken as symptoms of peri-implantitis that threaten to develop into implant rejection.
On a note
Peri-implantitis is called inflammation of the tissues adjacent to the implant - it can be both soft tissue and bone tissue. If the inflammatory process is not prevented in time, then these tissues will begin to gradually collapse, and the implant will become mobile - in fact, it will be rejected.
Signs of Dental Implant Rejection
After the implantation procedure, you will have to visit your doctor quite often: the first appointment will take place 2-3 days after implantation. Such examinations are very important for the timely detection of possible problems (it was already mentioned above that in case of rejection of the implanted construction, this process often occurs in the first days after the operation, so at this stage the control should be especially thorough).
The dentist will assess the stability of the implant and the condition of the tissues around it. Upon examination, it will become clear how well the structure fuses with the bone, whether there are signs of dangerous inflammation, and whether additional intervention is required to prevent unwanted complications.
Let's first see what unpleasant symptoms are considered normal after implantation. Since the implantation of implants is associated with tissue injury (even in the case of basal implantation by the puncture method), after the operation there are always some degree of discomfort and the corresponding external signs:
- swelling of the gums (sometimes the whole cheek swells);
- redness of the gums;
- soreness of the jaw in the area of the installed implant.
On a note
The indicated consequences of surgical intervention normally pass quite quickly, after 3-4 days (maximum - after a week). If you feel severe pain all week, and it does not go away or even intensifies, this is a sure sign that healing is not going fast enough. By the way, whether it comes to rejection of the implant, or everything will work out - it often depends not only on the doctor, but also on the actions of the patient himself (more on this below).
However, in some cases, for example, with simultaneous bone grafting, as well as in the presence of acute inflammatory processes in the hole, the rehabilitation process can take up to a couple of weeks.
Now let's consider what symptoms indicate a deviation from the course of normal rehabilitation after the installation of implants.
Generally speaking, some of the symptoms of dental implant rejection (or peri-implantitis - inflammation of the tissues around the structure) are in many ways similar to the usual post-operative consequences. However, they tend to be more pronounced and persist for a long time:
- acute pain that does not go away within 1-2 weeks after implantation;
- swelling and redness of the gums that persist for more than 4 days after surgery. Even in the most difficult cases, the edema subsides within 3-4 days, so if it persists longer, this is an alarming sign;
- prolonged bleeding from the wound, as well as prolonged release of the so-called exudate (ichorus). If such discharge lasts more than 7 days, this is not very good;
- mobility of dental implants - here in many cases you can immediately predict that the design is unlikely to take root in the future;
- if there is an unpleasant smell under the plugs installed on the implants;
- pus from the gums - an abscess can be located next to the implant and communicate with the focus of inflammation through the formation of a fistula, or pus can come directly from under the implant (sometimes there is an appearance of bad breath);
- soreness when pressing on the implant is a very characteristic sign that there are serious problems in the integration of the structure. In such cases, it is better not to wait for everything to pass by itself and “resolve”;
- increase in body temperature.
All of the above signs may indicate a possible rejection of the implant, their appearance at any stage of treatment requires immediate consultation with a specialist.
"Inflammation of the implant" of the tooth (or rather, the tissues surrounding it) can occur without symptoms, especially a few years after implantation of the structure into the bone. The patient may not pay attention to slight soreness and redness of the gums - a pronounced reaction to implant rejection may be absent, and inflammation, meanwhile, will lead to the destruction of bone tissue and, as a result, an increase in implant mobility.
This situation is further complicated by the fact that an additional operation will subsequently be required to restore the jawbone before re-implantation.
This is interesting:
On average, implants are rejected in no more than 3-5% of all cases, and the figures vary greatly depending on the brand of structures. For example, German or Swiss-made implants successfully take root in 97-98% of cases, and more affordable Israeli or Russian-made products - in about 95%.
The photo below shows an example of tissue inflammation in the area of the implant:
Why do dental implants sometimes fail?
In general, there are not so many reasons for rejection of dental implants. In most cases, the problem occurs due to a doctor's mistake during the procedure. Much less often - when choosing a low-quality or even fake implant (again, this can also be considered a medical error).
But the patient should not relax either - due to the peculiarities of the state of health or if certain rules of behavior are not observed during the rehabilitation period, rejection of dental implants may also occur. The symptoms of the onset of rejection in almost all cases will be the same, regardless of the causes that caused them.
Let's consider the possible causes of the problems in more detail.
The first reason: unprofessionalism or doctor's mistake
A characteristic feature in this case is that the implants begin to be rejected immediately, that is, during the engraftment period.
Unfortunately, dental implants are most often rejected precisely because of medical errors - this may be a lack of experience, especially when dealing with complex clinical cases, unprofessionalism, or just plain carelessness.
Here, for example, what mistakes an implantologist can make during work:
- improperly selected implant design - for this reason, the implant may not be able to properly fix in the bone (for example, it may be noticeably longer or thicker than the bone tissue);
- lack of sterility of the working instrument or the working area in the oral cavity (foci of acute inflammation were not eliminated) - as a result, an infection is initially present in the wound;
- tissue overheating when drilling a hole for an implant;
- incorrect positioning of the implant in the jaw;
- lack of sufficient information about the patient's health status - possible contraindications are not excluded.
Of particular difficulty for the doctor is the lack of a sufficient amount of bone tissue to secure the implant (for example, due to its atrophy) and acute inflammatory processes.
The problem of bone atrophy can be solved by its replanting or the choice of the method of basal implantation, in which implants of special design are used, which are fixed in the deepest basal parts of the bone tissue. However, rejection of basal implants can also occur at any stage of engraftment. According to statistics, they have to be removed at least as often as classic implants.
On a note:
Implantation in periodontitis and periodontal disease, that is, against the background of acute inflammation of the gums, associated with the destruction of bone tissue, is quite possible today. But not all implantologists will decide to install implants in the presence of such inflammatory processes. Basically, such a procedure is carried out simultaneously with the removal of a diseased tooth, and after implantation of implants, drug therapy is prescribed with a simultaneous increase in oral hygiene.
When implants are rejected due to acute inflammation of the jaw tissues, re-implantation is not always possible due to severe bone destruction.
The second reason for possible rejection: low-quality implant
Large dentistry works with dealer networks that supply implants directly from the manufacturer, which eliminates the possibility of receiving fakes. In smaller clinics, the situation is more complicated.
The photo below shows an example of corrosion of a low-quality implant:
The quality of the implant itself also plays an important role: the more expensive the system, the more advanced materials and technologies, as a rule, are used in the manufacture of the structure. Large companies producing implants spend large budgets on improving products and developing innovative technologies.
This is interesting:
The quality of engraftment, and hence the risk of possible rejection, largely depends on the material from which the implant is made (it must be titanium biocompatible with our body), as well as on the characteristics of its surface. Today, many manufacturers prefer a porous coating - growing cells of the jawbone penetrate into it, which ensures a strong fusion of the bone and the implant.
The third reason: violations on the part of the patient
In this case, the symptoms of implant rejection may appear both during the engraftment period and after several years of using new teeth.
It should be borne in mind that even if the doctor does all his work to install the implant perfectly, the wrong subsequent actions of the patient can negate even the best result of the treatment. What you need to pay attention to first of all:
On a note:
Practice shows that in smokers, dental implants are rejected much more often than in non-smokers. According to statistics, approximately 30% of smoking patients experience rejection symptoms within the first five years after surgery. As a result, the implants have to be replaced with new ones.
Toxic tar and nicotine lead to malnutrition of the mucosal cells, which has a very negative effect on the condition of the tissues around the implant. Ultimately, the structure loses its stability, becomes mobile, being rejected by the body.
The question arises: what should smokers do? The choice is not very great - either refuse implantation, or reconsider your lifestyle - stop smoking (or at least smoke less often).
The fourth reason leading to the rejection of dental implants: poor health
This reason leads to the rejection of implants, mainly a few years after their installation.
If the implants are not rejected in the first two years, then we can safely talk about the success of the treatment. But the problem may arise many years after the installation of structures. This is extremely rare and mainly due to either mechanical injury, or exacerbation or development of certain diseases: cardiovascular, diabetes, immune (AIDS), tuberculosis or oncological.
What to do if there is inflammation under the implant?
If there are alarming symptoms of inflammation in the area of the installed implant (there is a smell from under the implant, pain, reddening of the gums, swelling, etc.), the only right decision would be to immediately consult a doctor. The implantologist will conduct a visual examination of the condition of the installed implant, make an X-ray examination, and, if necessary, open the gum and help cleanse the wound from pus.
If the problems began during the engraftment period, then sometimes the cause of discomfort (for example, a putrid smell from the implant) is easily solved by temporarily unscrewing the implant plug and cleaning its outer surfaces.
But in the presence of obvious signs of peri-implantitis, in most cases, removal of the installed implant is indicated, and this must be done as soon as possible. Indeed, otherwise, neglected inflammation can lead to the spread of infection throughout the body, which is fraught with very serious consequences, up to a threat to the patient's life.
In addition, the longer there is inflammation in the area of the implant, the more the bone tissue around it is destroyed, and the more problems there may be in case of re-implantation.
Is re-implantation possible after implant rejection?
Re-implantation is possible in most cases. It should be borne in mind that after the removal of the rejected implant, no more than 1-2 months should pass - otherwise the bone tissue, not receiving the proper load, will gradually atrophy.
If necessary, bone grafting can be performed and drug therapy can be prescribed to suppress infection in the focus of inflammation. After restoration of damaged tissues, re-implantation is performed.
On a note
According to the law, there is no guarantee for surgical work, so the patient will have to rely on the conscience of the administration of the clinic or the doctor, who will fulfill the independently established guarantee obligations. A multi-year or indefinite guarantee for implants, which is established by the manufacturers of structures, is just the life of artificial teeth. But whether they will last the declared years depends on both the patient and the doctor.
How can you protect yourself in advance from possible problems associated with implant rejection
In conclusion, it is worth giving some useful tips that will minimize the possible problems associated with the rejection of installed implants.
So here are the tips:
- you should be aware in advance that the responsibility for the result of treatment lies not only on the shoulders of the doctor, but also on you too (an undisciplined patient who does not follow the instructions of the doctor can spoil the results of even the most exquisite work done);
- choose a clinic with a "name" - as a rule, large centers invest in modern equipment and staff training;
- choose a professional doctor with experience and positive recommendations and reviews (at the same time, choosing a doctor is more important than choosing a clinic);
- give preference to high-quality implants - not lower than the average price segment (you should choose well-known brands that have been on the market for at least 5-7 years);
- follow all the requirements of the doctor after the operation and monitor oral hygiene;
- and, of course, do not forget to regularly undergo preventive examinations of the oral cavity, treat diseases of the teeth and gums in a timely manner and take care of them daily.
In general, the risk of falling into the number of patients whose implants are rejected is minimal. It is much more likely that they will serve you faithfully for many decades, or even a lifetime.
An interesting video about the complications that can occur with dental implants
What to choose: implantation or crowns?
Oscar-winning actors usually thank God and their parents. People who restore their teeth and a comfortable lifestyle with the help of implantation should remember the Swedish professor Per-Ingvar Brånemark with a kind word. Quite by accident, he revolutionized dentistry.
In 1965, Brånemark was doing research with a group of scientists. The professor implanted a titanium capsule in the rabbit and was very surprised when he could not remove it. So a happy accident helped to establish that titanium fuses with bone. Brånemark decided to use the discovery in prosthetics.
The first lucky man with titanium implants is Gust Larsson. A simple carpenter, like Professor Brånemark, entered the history of implantology. Larsson, 34, had a completely toothless mouth. Not life, but torment: eating, talking, smiling - everything is difficult. The man himself found Brånemark, accidentally learning about his experiments.
The first experience was successful, but the patient Brånemark was in no hurry to announce a revolution in dentistry. The scientist spoke publicly about his discovery 20 years later. The post made a splash! An accidental discovery turned the world of prosthetics upside down and returned a comfortable lifestyle to edentulous patients.
Dental implantation of teeth is the implantation of an artificial root in the upper or lower jaw. The implant is titanium, so it is completely biocompatible. This secure crown support consists of:
- titanium screw (implanted in the jaw during surgery);
- abutment (attached to the implant, resembles a turned tooth).
The answer to the question of whether to do a dental implant is unequivocal: of course, yes. Today it is the most progressive method of prosthetics.
Operation in the posterior part of the chewing teeth.
Placement of an implant in the area of the anterior teeth.
The photo of dental implantation shows a clinical case when the patient has complete edentulous upper jaw and several teeth are missing on the lower jaw.
A variety of methods of dental implantation allow you to choose the ideal option for each patient.
Single stage
For those who do not want to wait a long time and who have no contraindications, dentists offer one-stage implantation with immediate loading. The peculiarity of the method is that the temporary prosthesis and the implant are fixed in one step. Only a small incision is made in the gum. The temporary crown is replaced with a permanent one after 3-5 months. During this time, the dental implant finally takes root.
two-stage
Two-stage implantation is time-tested. The operation takes more time, but the risk of complications is minimal - the doctor sees well what he is operating on due to the incision of the gums and the folding of its flap. The abutment is installed six months after the engraftment of the implant, the crown - one week after the abutment. This is a classic dental implantation, proposed by Professor Brånemark.
Simultaneous
Simultaneous - implantation takes place simultaneously with the removal of the tooth. It is ideal for anterior teeth where esthetics are at the forefront. For chewing teeth, this technique is rarely used.
- Installation of an implant. If the process of dental implantation goes without surprises, according to a pre-planned plan, the operation will take 20-40 minutes. First, the doctor will install the implant, then check the degree of primary stabilization, and then decide whether to load it with a crown or not.
before implantation. Dental implantation of teeth, like any other operation, requires careful preparation. The result depends on it. The doctor should plan the implantation procedure as accurately as possible and identify all possible contraindications. At the first appointment, the implantologist asks general health questions. Referral to analyzes and consultations of other specialists is given if necessary. The oral cavity should be healthy - without caries and inflammation of soft tissues. A few days before the operation, you need to sign up for a cleaning.
Anesthesia. As a rule, local anesthesia is used for implantation. Modern drugs completely relieve the patient from pain and discomfort. If necessary, sedation or anesthesia is applied.
Crown fixation. The temporary crown is fixed when the dental implant is firmly anchored in the bone. In case of problems with the primary stabilization of the implant, only the gingiva former will be placed. A permanent crown can be placed after the complete engraftment of the artificial root, after 3-5 months. An abutment will be fixed on the implant, and a permanent crown will be fixed on it.
A typical problem that can happen with dental implants is their rejection. A very common question is, how do dental implants take root? Statistics assures that on average 85-96% of implants take root, in severe cases up to 80%. The use of modern technologies, such as basal implantation, can increase this figure to 97% for complex cases and more than 99% for simple cases.
Survival of dental implants largely depends on the lifestyle of the patient. For example, with active smoking, the percentage of rejections is significantly higher, which is associated with impaired blood circulation in the gums. Dental implants do not take root in people suffering from insulin-dependent diabetes mellitus, there are difficulties with survival in hypertensive patients. If you violate the recommendations of the doctor, and immediately chew solid food on the operated tooth, there will be problems.
Also, the survival rate of the implant largely depends on its type. Most manufacturers claim that their products can last up to 20-50 years, and some as long as the rest of their lives. Titanium, from which implants are made today, is a completely inert material and does not cause rejection.
When to wait for a dental implant rejection?
If the implant does not take root, then its rejection must be expected within the first few months (usually it takes up to six months for it to take root). It happens that the implant is rejected after 2-3 years, but such cases are rare and can be expressed, among other things, in the form of tissue inflammation. Usually, the reason for rejection of the implant at this stage is an injury, or some kind of disease. Finally, sometimes implants fall out after 5-6 years, which often indicates poor quality work.
The main signs of implant rejection:
- bleeding from a wound that does not stop within 2-4 days (other reasons: decreased blood clotting, taking drugs that thin the blood)
- redness and swelling of the gums
- acute pain not relieved by painkillers (slight aching pain in the jaw, which is easily eliminated by painkillers, is considered the norm, provided that it stops within 2-4 days)
- purulent discharge from the implant site (rare).
Rejection of a dental implant can occur as a result of an exacerbation of the disease, injury (and displacement or damage to the implant), insufficient oral hygiene, ignoring the doctor's recommendations by the patient and non-compliance with medical treatment. Regardless of the symptoms and reasons for rejection, contact your doctor immediately. He will be able to help.
What to do if a dental implant falls out?
Go immediately to the doctor. However, when they say that a dental implant has fallen out, they usually mean that the crown (prosthesis) has fallen off. The implant itself does not fall out - it is implanted into the bone and its loss is basically impossible. Also, the implant and the pin are often confused - these are different things. Loss of the prosthesis is possible in several cases: incorrectly done work (this is a warranty case), non-compliance with the doctor's recommendations.
We do not allow this in our work. We are not approached for the re-installation of implants, pins and crowns, but sometimes we encounter such cases when patients come to us with implants already installed: specialists will help to correct poor-quality work.
Other problems
Can I have an MRI with implants in my mouth? Of course, only non-fixed metal objects are contraindications, while the implant is firmly fixed. In other words, MRI dental implants are not a hindrance.
fdc-vip.ru
Symptoms of tooth implant rejection: how to recognize the problem?
- What symptoms are usually accompanied by implant rejection and when exactly problems can begin;
- How long do implants take root and why are they sometimes rejected;
- What sensations are considered normal after a recent operation, and which are signs of dangerous inflammation in the area of the implant;
- What to do if inflammation has begun and whether re-implantation is possible after rejection of the implanted structure.
... And also some other interesting and practical nuances regarding the problem of implant rejection.
It should be understood that dental implantation is a rather complicated and to some extent traumatic procedure, the process of tissue healing after which does not always proceed smoothly: swelling, bleeding, pain due to injury to the gums and jawbone are possible. However, all these are normal consequences of surgical intervention, which disappear on their own after a few days.
But there are also complications that require surgical intervention by a doctor. And, perhaps, the most unpleasant of them is the rejection of a tooth implant. The first symptoms of this problem are, as a rule, acute pain, mobility of the structure, the appearance of an unpleasant odor, as well as redness and swelling of the mucosa near the outer part of the implant (abutment, plug).
Generally speaking, implant rejection is quite rare today, and patients do not need to pre-adjust to an unfavorable outcome of the operation. However, it is imperative to know the characteristic signs of incipient rejection, to understand what causes inflammation under the implant - it is always useful to be prepared for possible complications in theory in order to prevent their occurrence in practice.
How long do implants usually take to heal and when can they be rejected?
The average healing time of implants is about 2-4 months in the lower jaw and about six months in the upper jaw. This difference is explained by the fact that the bones of the lower jaw are better supplied with blood, they are generally larger and stronger, they have a higher chewing load. In addition, the nasal sinus is located above the bone tissue of the upper jaw, the proximity of which often introduces additional difficulties when installing implants.
Osseointegration (this is the medical term for the process of fusion of metal roots with the jawbone) begins immediately after the installation of structures. The terms of engraftment largely depend on the initial state of the jawbone, as well as on the quality of manufacture and the model of the implant itself.
At the same time, the method by which the implants were installed in the jaw does not play a special role. Regardless of whether the implants are loaded immediately (for example, with basal implantation), or only after complete fusion with the bone, in both cases, the healing time does not differ much.
According to statistics, if the rejection of implants does occur, then in most cases this is observed in the first days after their installation. In other words, if something went wrong, then the first symptoms of a complication, as a rule, do not take long.
However, the patient should not lose vigilance even after successful engraftment of the structure - inflammation after implantation of teeth with subsequent rejection of the implant can overtake even after several years of its active operation.
The photo below shows a relevant example (inflammation began 10 years after the implant was placed):
Below we will see what can be done to avoid this unfavorable outcome. However, before that, let's talk about what sensations are considered normal after dental implantation, and which should be taken as symptoms of peri-implantitis that threaten to develop into implant rejection.
On a note
Peri-implantitis is called inflammation of the tissues adjacent to the implant - it can be both soft tissue and bone tissue. If the inflammatory process is not prevented in time, then these tissues will begin to gradually collapse, and the implant will become mobile - in fact, it will be rejected.
Signs of Dental Implant Rejection
After the implantation procedure, you will have to visit your doctor quite often: the first appointment will take place 2-3 days after implantation. Such examinations are very important for the timely detection of possible problems (it was already mentioned above that in case of rejection of the implanted construction, this process often occurs in the first days after the operation, so at this stage the control should be especially thorough).
The dentist will assess the stability of the implant and the condition of the tissues around it. Upon examination, it will become clear how well the structure fuses with the bone, whether there are signs of dangerous inflammation, and whether additional intervention is required to prevent unwanted complications.
Let's first see what unpleasant symptoms are considered normal after implantation. Since the implantation of implants is associated with tissue injury (even in the case of basal implantation by the puncture method), after the operation there are always some degree of discomfort and the corresponding external signs:
- swelling of the gums (sometimes the whole cheek swells);
- redness of the gums;
- soreness of the jaw in the area of the installed implant.
On a note
The indicated consequences of surgical intervention normally pass quite quickly, after 3-4 days (maximum - after a week). If you feel severe pain all week, and it does not go away or even intensifies, this is a sure sign that healing is not going fast enough. By the way, whether it comes to rejection of the implant, or everything will work out - it often depends not only on the doctor, but also on the actions of the patient himself (more on this below).
However, in some cases, for example, with simultaneous bone grafting, as well as in the presence of acute inflammatory processes in the hole, the rehabilitation process can take up to a couple of weeks.
Now let's consider what symptoms indicate a deviation from the course of normal rehabilitation after the installation of implants.
Generally speaking, some of the symptoms of dental implant rejection (or peri-implantitis - inflammation of the tissues around the structure) are in many ways similar to the usual post-operative consequences. However, they tend to be more pronounced and persist for a long time:
- acute pain that does not go away within 1-2 weeks after implantation;
- swelling and redness of the gums that persist for more than 4 days after surgery. Even in the most difficult cases, the edema subsides within 3-4 days, so if it persists longer, this is an alarming sign;
- prolonged bleeding from the wound, as well as prolonged release of the so-called exudate (ichorus). If such discharge lasts more than 7 days, this is not very good;
- mobility of dental implants - here in many cases you can immediately predict that the design is unlikely to take root in the future;
- if there is an unpleasant smell under the plugs installed on the implants;
- pus from the gums - an abscess can be located next to the implant and communicate with the focus of inflammation through the formation of a fistula, or pus can come directly from under the implant (sometimes there is an appearance of bad breath);
- soreness when pressing on the implant is a very characteristic sign that there are serious problems in the integration of the structure. In such cases, it is better not to wait for everything to pass by itself and “resolve”;
- increase in body temperature.
All of the above signs may indicate a possible rejection of the implant, their appearance at any stage of treatment requires immediate consultation with a specialist.
"Inflammation of the implant" of the tooth (or rather, the tissues surrounding it) can occur without symptoms, especially a few years after implantation of the structure into the bone. The patient may not pay attention to slight soreness and redness of the gums - a pronounced reaction to implant rejection may be absent, and inflammation, meanwhile, will lead to the destruction of bone tissue and, as a result, an increase in implant mobility.
This situation is further complicated by the fact that an additional operation will subsequently be required to restore the jawbone before re-implantation.
This is interesting:
On average, implants are rejected in no more than 3-5% of all cases, and the figures vary greatly depending on the brand of structures. For example, German or Swiss-made implants successfully take root in 97-98% of cases, and more affordable Israeli or Russian-made products - in about 95%.
The photo below shows an example of tissue inflammation in the area of the implant:
Why do dental implants sometimes fail?
In general, there are not so many reasons for rejection of dental implants. In most cases, the problem occurs due to a doctor's mistake during the procedure. Much less often - when choosing a low-quality or even fake implant (again, this can also be considered a medical error).
But the patient should not relax either - due to the peculiarities of the state of health or if certain rules of behavior are not observed during the rehabilitation period, rejection of dental implants may also occur. The symptoms of the onset of rejection in almost all cases will be the same, regardless of the causes that caused them.
Let's consider the possible causes of the problems in more detail.
The first reason: unprofessionalism or doctor's mistake
A characteristic feature in this case is that the implants begin to be rejected immediately, that is, during the engraftment period.
Unfortunately, dental implants are most often rejected precisely because of medical errors - this may be a lack of experience, especially when dealing with complex clinical cases, unprofessionalism, or just plain carelessness.
Here, for example, what mistakes an implantologist can make during work:
- improperly selected implant design - for this reason, the implant may not be able to properly fix in the bone (for example, it may be noticeably longer or thicker than the bone tissue);
- lack of sterility of the working instrument or the working area in the oral cavity (foci of acute inflammation were not eliminated) - as a result, an infection is initially present in the wound;
- tissue overheating when drilling a hole for an implant;
- incorrect positioning of the implant in the jaw;
- lack of sufficient information about the patient's health status - possible contraindications are not excluded.
Of particular difficulty for the doctor is the lack of a sufficient amount of bone tissue to secure the implant (for example, due to its atrophy) and acute inflammatory processes.
The problem of bone atrophy can be solved by its replanting or the choice of the method of basal implantation, in which implants of special design are used, which are fixed in the deepest basal parts of the bone tissue. However, rejection of basal implants can also occur at any stage of engraftment. According to statistics, they have to be removed at least as often as classic implants.
On a note:
Implantation in periodontitis and periodontal disease, that is, against the background of acute inflammation of the gums, associated with the destruction of bone tissue, is quite possible today. But not all implantologists will decide to install implants in the presence of such inflammatory processes. Basically, such a procedure is carried out simultaneously with the removal of a diseased tooth, and after implantation of implants, drug therapy is prescribed with a simultaneous increase in oral hygiene.
When implants are rejected due to acute inflammation of the jaw tissues, re-implantation is not always possible due to severe bone destruction.
The second reason for possible rejection: low-quality implant
Large dentistry works with dealer networks that supply implants directly from the manufacturer, which eliminates the possibility of receiving fakes. In smaller clinics, the situation is more complicated.
The photo below shows an example of corrosion of a low-quality implant:
The quality of the implant itself also plays an important role: the more expensive the system, the more advanced materials and technologies, as a rule, are used in the manufacture of the structure. Large companies producing implants spend large budgets on improving products and developing innovative technologies.
This is interesting:
The quality of engraftment, and hence the risk of possible rejection, largely depends on the material from which the implant is made (it must be titanium biocompatible with our body), as well as on the characteristics of its surface. Today, many manufacturers prefer a porous coating - growing cells of the jawbone penetrate into it, which ensures a strong fusion of the bone and the implant.
The third reason: violations on the part of the patient
In this case, the symptoms of implant rejection may appear both during the engraftment period and after several years of using new teeth.
It should be borne in mind that even if the doctor does all his work to install the implant perfectly, the wrong subsequent actions of the patient can negate even the best result of the treatment. What you need to pay attention to first of all:
On a note:
Practice shows that in smokers, dental implants are rejected much more often than in non-smokers. According to statistics, approximately 30% of smoking patients experience rejection symptoms within the first five years after surgery. As a result, the implants have to be replaced with new ones.
Toxic tar and nicotine lead to malnutrition of the mucosal cells, which has a very negative effect on the condition of the tissues around the implant. Ultimately, the structure loses its stability, becomes mobile, being rejected by the body.
The question arises: what should smokers do? The choice is not very great - either refuse implantation, or reconsider your lifestyle - stop smoking (or at least smoke less often).
The fourth reason leading to the rejection of dental implants: poor health
This reason leads to the rejection of implants, mainly a few years after their installation.
If the implants are not rejected in the first two years, then we can safely talk about the success of the treatment. But the problem may arise many years after the installation of structures. This is extremely rare and mainly due to either mechanical injury, or exacerbation or development of certain diseases: cardiovascular, diabetes, immune (AIDS), tuberculosis or oncological.
What to do if there is inflammation under the implant?
If there are alarming symptoms of inflammation in the area of the installed implant (there is a smell from under the implant, pain, reddening of the gums, swelling, etc.), the only right decision would be to immediately consult a doctor. The implantologist will conduct a visual examination of the condition of the installed implant, make an X-ray examination, and, if necessary, open the gum and help cleanse the wound from pus.
If the problems began during the engraftment period, then sometimes the cause of discomfort (for example, a putrid smell from the implant) is easily solved by temporarily unscrewing the implant plug and cleaning its outer surfaces.
But in the presence of obvious signs of peri-implantitis, in most cases, removal of the installed implant is indicated, and this must be done as soon as possible. Indeed, otherwise, neglected inflammation can lead to the spread of infection throughout the body, which is fraught with very serious consequences, up to a threat to the patient's life.
In addition, the longer there is inflammation in the area of the implant, the more the bone tissue around it is destroyed, and the more problems there may be in case of re-implantation.
Is re-implantation possible after implant rejection?
Re-implantation is possible in most cases. It should be borne in mind that after the removal of the rejected implant, no more than 1-2 months should pass - otherwise the bone tissue, not receiving the proper load, will gradually atrophy.
If necessary, bone grafting can be performed and drug therapy can be prescribed to suppress infection in the focus of inflammation. After restoration of damaged tissues, re-implantation is performed.
On a note
According to the law, there is no guarantee for surgical work, so the patient will have to rely on the conscience of the administration of the clinic or the doctor, who will fulfill the independently established guarantee obligations. A multi-year or indefinite guarantee for implants, which is established by the manufacturers of structures, is just the life of artificial teeth. But whether they will last the declared years depends on both the patient and the doctor.
How can you protect yourself in advance from possible problems associated with implant rejection
In conclusion, it is worth giving some useful tips that will minimize the possible problems associated with the rejection of installed implants.
So here are the tips:
- you should be aware in advance that the responsibility for the result of treatment lies not only on the shoulders of the doctor, but also on you too (an undisciplined patient who does not follow the instructions of the doctor can spoil the results of even the most exquisite work done);
- choose a clinic with a "name" - as a rule, large centers invest in modern equipment and staff training;
- choose a professional doctor with experience and positive recommendations and reviews (at the same time, choosing a doctor is more important than choosing a clinic);
- give preference to high-quality implants - not lower than the average price segment (you should choose well-known brands that have been on the market for at least 5-7 years);
- follow all the requirements of the doctor after the operation and monitor oral hygiene;
- and, of course, do not forget to regularly undergo preventive examinations of the oral cavity, treat diseases of the teeth and gums in a timely manner and take care of them daily.
In general, the risk of falling into the number of patients whose implants are rejected is minimal. It is much more likely that they will serve you faithfully for many decades, or even a lifetime.
An interesting video about the complications that can occur with dental implants
What to choose: implantation or crowns?
plomba911.ru
Tooth implant fell out: what to do?
Rejection of artificial roots is a rather rare, but very unpleasant problem that occurs after implantation. Its probability directly depends on the lifestyle of a person. If the patient is an active smoker, respectively, the percentage of probability will be much higher, because the blood circulation in the gums is disturbed. Also, poor survival is observed in hypertensive, insulin-dependent diabetics. To prevent the tooth implant from falling out, you must follow all the instructions. Do not eat solid food immediately after surgery. Big problems can arise due to non-compliance with the doctor's recommendations.
Also, the adaptability of an artificial root largely depends on the material from which it is made. Titanium is by far the strongest. It is completely inert and does not cause rejection. Many manufacturers claim that such products will last you 50 years or more.
According to statistics, up to 98 percent of artificial roots lend themselves to engraftment. However, the following symptoms should alert patients and encourage them to go to the clinic.
The main signs of rejection:
- ichor from the wound, continuing for more than 4 days;
- redness and swelling of the gums;
- severe pain that is not controlled by painkillers. (a slight aching jaw pain, easily eliminated by painkillers, is the norm if it stops within 2-3 days);
- discharge of pus at the implant site (rare).
What actions to take?
The only solution is to immediately go to the doctor. Saying that the implant fell out, they usually mean the separation of the crown. The screw itself cannot fall out, because it is implanted into the bone. Falling out of the prosthesis can occur if the work of the dentist is not done correctly and if his recommendations were not followed later.
Usually, the doctor observes the installed structure for two years. It is at this time that all sorts of complications can arise. In this case, the doctor will immediately prescribe the necessary treatment and help to avoid many problems. In order not to worry about whether rejection will occur, the patient should make a responsible choice of clinic and a competent doctor, making sure of his qualifications.
What can be done to avoid implant prolapse?
The most important thing in this case is to strictly follow all the recommendations that the doctor has given you. After implantation, you will be prescribed antibiotics and painkillers. They must be taken in those dosages and at the frequency indicated by the doctor. The prescribed diet should be followed. A sparing diet involves minimal mechanical impact on the installed artificial teeth and mucous membranes. Soft and pureed food is recommended.
It is worth remembering oral hygiene. Use a soft toothbrush to clean temporary structures. Be careful when cleaning, try not to touch the seams. Dentures should be cleaned 2-3 times a day, along with an antiseptic rinse. Particular attention during cleaning should be given to the so-called suprastructures: these are the protruding parts of the implant above the gum. In addition, thoroughly clean the part of the structure adjacent to the gum. These principles of hygiene will prevent the accumulation of pathogens and further rejection.
myimplants.ru
The main signs and causes of dental implant rejection
With modern materials and technologies, the risks of rejection of a tooth implant are quite low. But in order to recognize it in time, you need to know about the symptoms, signs and causes of this phenomenon. And if you follow all the doctor's recommendations and preventive measures, you can easily avoid this.
The implantation procedure is considered safe for the body in most cases, but there are some moments when the body does not accept a foreign body. If you notice this in time and seek help from specialists, they will fix the problem and try to choose a different material for the pin or another method of prosthetics.
How long does a dental implant last?
Let's try to figure out how long it takes for the implanted titanium rod to start functioning as a natural tooth root and not cause discomfort. In this case, there is a direct dependence on which jaw the operation was performed on:
- On the lower one, the normal engraftment time is limited to 2-4 months, since there is usually a good blood supply to the tissues and sufficient volumes of the jawbone. As a result, a foreign object rarely causes rejection and does not create a negative effect on the surrounding tissues. During implantation, the integrity of the jaw is not violated, and wounds heal faster.
- At the top, the process can take up to six months, which is the norm according to medical indications. After all, its structure is much more complicated, and next to the location of the new implant there are other organs that are sensitive to foreign materials - the maxillary and nasal sinuses, facial bones, etc. The upper jaw is more fragile, thin and has less blood supply. Due to this, complications after dental and surgical interventions occur much more often, and implants take longer to take root.
Causes of Dental Implant Rejection
Why do artificial roots easily take root in some people even when several rods are installed at once, while in others problems arise immediately after the first surgical intervention?
We will try to describe in more detail the main factors provoking this phenomenon. They can mainly be divided into those that depend on the quality of the work of the dentist and the reasons associated with the health or wrong actions of the patient.
They appear in different time frames:
- short-term - unpleasant symptoms are observed from the first days of the pin installation, even when the crown is not yet fixed - the upper part of the artificial tooth;
- medium-term - rejection occurs in the first two years after surgery;
- long-term - problems happen much later.
Poor quality work of a specialist during the implantation procedure
One of the most important factors affecting the duration of use of the implant and the likelihood of its rejection is the professionalism of the doctor. There are the following main errors:
- use of outdated tools, low-quality equipment;
- poor antiseptic surface treatment;
- carrying out the operation by different specialists at certain stages of implantation, when the second doctor does not know all the nuances of the patient's condition and the manipulations performed;
- violations of the protocol of the procedure, unjustified changes in the sequence of actions;
- omission of separate information about the health and well-being of a person, a frivolous attitude to contraindications.
Poor product quality
When trying to save money, you can also make mistakes. Choosing cheap analogues, patients do not always pay attention to the composition of the metal alloy from which the implant is made. And this is largely reflected in the likelihood of engraftment of the product and the duration of its use.
It is very important for such a procedure to choose a really high-quality rod that will not cause an adverse reaction of the body and will not have a toxic effect in the future.
Allergic reaction
Some people have a predisposition to rejection of metallic elements. And although today in dentistry for such products only medical titanium or zirconium dioxide is chosen, which are most compatible with human tissues, it is still better to make special samples initially to eliminate risks.
Various internal diseases
In the presence of violations of the body systems, it is necessary to correlate the danger and benefit of each procedure. So, with bronchial asthma, lupus erythematosus, lichen and other similar pathologies, surgical intervention can be dangerous.
In addition, there are other problems. With the constant use of hormonal or other drugs, bone metabolism sometimes decreases, regeneration processes worsen, which will also lead to rejection of the implant.
Therefore, it is always necessary to warn the doctor about the presence of chronic diseases, so that he makes a more rational decision in each case.
Frivolous behavior of the patient
No need to think that in the presence of artificial teeth, you can neglect their cleaning and normal oral hygiene. Implants need the same quality care as natural tissues.
Doctors draw the attention of patients to the fact that smoking and alcohol significantly worsen the condition of soft and hard tissues. Therefore, if you do not follow their recommendations to quit smoking in the postoperative period, then such an addiction will sooner or later lead to rejection of the artificial material.
It is important to observe other usual rules. Daily cleaning should be complemented by periodic professional treatments. And from the remnants of food and bacteria, the oral cavity should be cleaned several times a day. Such prevention will help not only to avoid rejection, but also contributes to the preservation of still healthy teeth and gums.
Symptoms
Since unpleasant consequences can occur both immediately after the operation and much later, you need to be able to recognize the signs of dental implant rejection in the early stages. Important among them are:
- swelling of the mucosa that does not subside for more than five days after the intervention;
- bleeding - at first it is the result of implantation of a structure and an open wound, but after 1-2 days it should normally stop, if this does not happen, then it is considered a sign of inflammatory processes or vascular damage;
- pain - when they do not go away even a week after the operation, this also indicates internal problems;
- high temperature - on the first day it is considered a normal reaction of the body to the intervention, but if it continues to rise three days after that, it threatens with different consequences;
- an unpleasant odor or purulent discharge from the wound is the most obvious sign of tissue infection;
- the mobility of the implant, which appeared immediately or even several years after installation, speaks of the rejection that has begun and portends its imminent loss.
In each of these cases, even if there is only one unpleasant symptom, you need to see a doctor. He will establish the main problem and the cause that caused the non-standard reaction, and eliminate it in a timely manner.
Knowing how rejection occurs, you can immediately get an appointment with a specialist. He will open the problem area of the gums, remove the implant itself, clean the affected tissues from infection and restore the bone if necessary. If possible, after some time, the product will be reinstalled with the precautions taken.
Video: When does a dental implant fail?
How to avoid rejection?
Today in medicine, high-quality biocompatible and hypoallergenic materials are used to create implants, which in very rare cases cause rejection. European and American manufacturers indicate such risks only in 1-3% of cases, and even Asian counterparts are produced with a 95% quality guarantee.
And yet, in order to prevent possible troubles, you need to follow the individual points:
- When choosing a procedure and suitable products, it is necessary to take into account, first of all, the characteristics of your body and state of health.
- If the doctor has determined that you have certain contraindications for implantation, then you do not need to insist on it. It is better to give preference to other methods of prosthetics.
- When choosing a dental clinic and a specialist who will perform the procedure, pay attention to the availability of certificates, licenses and positive feedback from regular customers.
- The quality of the equipment used during the doctor's work is also important. It is worth noting that in large private centers they usually monitor the timely updating of equipment and try to acquire the latest tools and high quality materials.
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A typical problem that can happen with dental implants is their rejection. A very common question is, how do dental implants take root? Statistics assures that on average 85-96% of implants take root, in severe cases up to 80%. The use of modern technologies, such as basal implantation, can increase this figure to 97% for complex cases and more than 99% for simple cases.
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