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Dental Implant Failures - Patient Information and Prevention

hi it's dr. Adrienne Kat from event and

artistry here in West Perth when dental

implants fire will I want to really

discuss from a patient's point of view

the different types of failures and also

how to prevent dental implant failures

or dental implants have been around

since the 1950s and of course they're

very common practice now to replace

missing teeth there are probably about

10 to 15 major brands of implants and

really there's up to 200 individual

brands of implants that available to

market so you can imagine that even in

the USA on an annual basis there are

about half a million implants placed

that's five hundred thousand implants

every year when you consider that from

research papers or success rates are

around about 96 to maybe ninety eight

percent of implants even if we choose

something in the middle say three

percent we're still going to be seeing

around about 15,000 complications just

in the USA alone when it comes to

implants there are three categories of

failures and from a basic point of view

we're looking at biomechanical failures

and this is when say the implant

actually fails maybe there's a fracture

fracture of the screw a fracture of the

implant there's also of course cosmetic

changes that actually occur and this is

a cosmetic failure where when a patient

actually looks at the implant looks at

the gum around the implant the implant

doesn't really look right and the last

thing is infectious chambers where

there's a problem with either the gum or

the bone and this is what I would like

to discuss today is these infectious

problems in facials problems with

implants is what we call peri-implant

disease and this is very similar suppose

to periodontal disease when we look

around natural teeth there are two types

of peri-implant disease ones what we

call primary problems which usually

happens before the implant is actually

loaded and this happens within the first

three six months this is sometimes

called rejection or this is when the

bone doesn't grow into the implant at

times this can be painful it's usually

painless actually and we do see some

swelling and redness of the

and it happens very early on so this is

just when the implants they placed it

hasn't had a chance to heal and usually

the implant hasn't been loaded so

there's no crown or bridge on top of the

implant and that's what we call a

primary failure the second part is the

secondary infection or a secondary

failure and this is after loading so

this is usually three to six months

after an implant has been placed and now

we're seeing problems there certain

stages when we look at implant failure

of course there's a healthy implant

we're at implants place to replace a

tooth and everything goes to plan of

three five ten years later the implant

still looks like a natural tooth at

functions and it appears as a normal

tooth in the mouth and this is what

every dentists inpatient of course once

there's a condition called mucositis

which is actually an inflammation of the

gum and I suppose when we look in our

from a layman's point of view it's

really just like gingivitis around the

tooth is usually caused by bacteria and

there's inflammation of the gum and this

inflammation of course means that there

could be some bleeding of the gum there

could be some bleeding on probing by the

dentist and we normally find that

there's a lot of redness associated with

the tissues from here we have what we

call peri-implantitis and again from a

layman's point of view it's like gum

disease around a natural tooth we

normally get pain we sometimes get some

swelling sand draining there's always

infection and there's swelling and

bleeding and this is a problem because

peri-implantitis is really about bone

loss around the tooth if this progresses

past a certain point we then see implant

failure so what are the ways to actually

prevent implant problems well there's

kind of two categories to this there's

the dentist site and of course there's

the patient side when it comes to the

dentist side the design of the crown or

the bridge is actually critical things

like is the bridge or whatever goes on

top of the implant is a cleanser ball do

they have nice contact points between

implant teeth so that food doesn't get

caught or plaque doesn't get caught

around it is the implant actually screw

retain or cemented is there a

possibility

that cement maybe around the implant and

what is the type of abutment or is a

titanium a Konya what side type of

abutment is on the crown the second part

when it comes to the dentist factors

here is also the implant position this

is why it's very important to actually

not only use the right brand of implant

but have a very experienced surgeon

that's placing implants if the position

of the implant is actually wrong maybe

it's too deep to shallow is too far to

the front of the mouth to parts of the

back of the mouth or maybe we have the

problem where the soft tissue is not

quite right around the implant what we

will see is we will see failure and the

last thing that a dentist can control is

of course the implant system we look at

whether it's an internal or external

connection is that a bone or tissue

level and what is the surface what type

of surface or titanium surface is on the

implant itself again very important that

the clinician that's placed in the

implant is very experienced the brand of

implant is very important and all of

these factors will determine how long an

implant will actually last when it comes

to patient factors I suppose the most

important in his general health patients

with cardiovascular problems a patient

of course smoked or have diabetes have a

much higher risk of failure because of

their general health we also can see

patients on anti-inflammatory so it's

not anti-inflammatory any depressant

drugs also have a highly a rate of

failure the other thing is that the

mouth must be clean we must actually see

no periodontal or gum disease around

adjacent teeth or anywhere in the mouth

and naturally we also can't see any sort

of infections around teeth that are next

to the implant and the last thing is

just you generalized cleaning and

maintenance the patient must have an

excellent oral hygiene especially if

they've got implants in their mouth that

are associated or next to natural teeth

all of these factors are very important

when it comes to longevity of implants

there is going to be another video on a

prevention and treatment of folding

if you have any questions please give it

to wring out 100 smiling I look forward

to one day seeing you in the practice