A dental implant: what can go wrong before you receive the crown on your implant?
For those not familiar with dental implants, here’s some basic information: Once the tooth has been removed and the bone in the area is stable, an implant usually made out of titanium, is placed in the area. This is a tubular shaped rod with a threaded incline in the middle of the rod. During the healing phase a healing cap, which looks like the head of a screw, is placed inside the threaded area to allow the gum tissue to heal properly. When the implant is integrated into the bone so that it is secure (called “osteointegration”), then the final crown can be made for that implant.
One thing that can go wrong is that the screw can come loose. I had a patient come in yesterday and the healing cap had come off the prior evening. When she arrived at 4 pm, the entire hole had closed up and there was no way to place the healing cap back. I referred her back to the surgeon for this procedure. Her implant looks like it is secure, so we will have to wait 2 weeks before taking an impression for the final crown.
Another problem is if the implant does not become secure in the bone. This is indeed a big problem. Frequently bone density scans can determine if the case is a poor candidate on this. Even so, I have one patient where we are waiting a little longer to see if the implant will tighten up (this was based upon radiographic evidence). I have another patient who has some medical issues. This patient has some existing implants that are doing fine, but the last couple have failed after waiting more than the usual amount of time for them to become secure.
Implants, in particular single unit implants, work great without a hitch most of the time. But there can be a few inconveniences along the way, and on rare occasion, a major failure that needs a reworking of the case. In the long run, implants and crowns usually prove to be well worth the effort.