Why are some implant cases difficult?


When someone loses a tooth and wants it restored, current opinion is that an implant is the way to go.  But there can be complications that make implants a more difficult solution.


Considering the oral components, the first thing is the anatomy. In an upper tooth, if there is not enough bone or the sinuses are too low, a sinus lift might have to take place. The surgeon can lift the sinus and induce bone growth so that the implant will have enough bone to anchor the implant. Another problem is that there is not enough attached gingiva in the area. This gum tissue is attached to the bone, and there must be an adequate amount of this so that the implant, just like a tooth, will not experience recession. On the same thinking, there are muscle attachments in the mouth (known as a frenum or frenulum) which can tug on the attached gingival and cause recession.


In a lower implant, instead of worrying about the sinus, we are concerned about the location of the mandibular nerve. This nerve runs through the lower jaw and must not be disturbed with an implant. With the new 3D scanning technology for surgeons, there is a lot more safety here.


The overall health of the patient plays a part in this. Although minor surgery, it is still surgery. If the patient’s condition is likely to slow healing, it is prudent to wait for the patient to become stronger before proceeding. I recently had a patient who is having a kidney problem. Two procedures did not take, and no implant was placed. He is now on dialysis and is hoping for the same kind of successful outcome he has had in the past with the same procedure.

Some habits, namely smoking, can add to the higher risk of failure. I am not a smoker so I don’t personally understand the addiction. But for many it is an addiction, and dental implant failure goes up four times in smokers.

If the patient had teeth in the wrong position and needed braces before needing the implant, the bite may be a problem when all is done. In some cases, orthodontic correction is a good idea before implant placement.

So, before getting a dental implant, make sure that potential complications are addressed before having to deal with the dental complication!