A dental implant functions as an artificial tooth root, providing a stable foundation for a replacement tooth. The titanium implant fixture is designed to fuse directly with the jawbone through a process called osseointegration. While the fixture is intended to be a lifelong replacement, the visible prosthetic tooth attached to it will eventually require replacement due to normal wear. Needing attention over time does not signify a complete system failure.
The Expected Lifespan of Implants
The dental implant system consists of three main parts: the fixture, the abutment, and the restoration. The implant fixture boasts a high success rate, often exceeding 95% over decades of use. This long-term stability means the fixture is considered a permanent replacement for the natural tooth root.
The restoration (crown, bridge, or denture) is the part most likely to need replacement. This prosthetic component endures daily chewing forces and general wear and tear, similar to a natural tooth. Crowns last between 10 and 15 years, though some can last up to 25 years depending on the material and care. Replacing the crown is a common maintenance procedure and does not mean the entire implant has failed.
Reasons for Premature Implant Failure
The titanium fixture can fail, requiring its removal and replacement, due to biological or mechanical causes. A primary biological cause is peri-implantitis, a progressive inflammatory condition affecting the gum tissue and bone surrounding the implant. This bacterial infection leads to the loss of supporting jawbone, eventually causing the implant to become loose. Patients who smoke, have diabetes, or maintain poor oral hygiene are at a greater risk of developing peri-implantitis.
Failures can occur early if the implant does not properly fuse with the jawbone, known as failed osseointegration. This happens due to poor bone density, premature force applied to the implant, or infection at the surgical site. Mechanical issues include the loosening or fracture of the abutment screw connecting the crown to the implant. Excessive chewing force, often from teeth grinding (bruxism), or improper placement can put undue stress on the components, potentially fracturing the implant body.
Maintaining Implant Longevity
Maintaining the longevity of the implant fixture requires consistent home care to prevent bacterial buildup. Brushing twice daily with a soft-bristled toothbrush and a low-abrasive toothpaste is recommended to clean the implant surface gently. Daily flossing is important around the abutment and gum line to remove debris and bacteria that a toothbrush cannot reach. Specialized tools like water flossers or interdental brushes are effective for cleaning the complex contours around the implant.
Professional maintenance is a necessary part of long-term care, often requiring cleanings every three to six months. Dental professionals use specialized instruments, made of plastic or titanium, to clean around the implant without scratching its surface. Avoiding hard or sticky foods helps prevent mechanical trauma to the crown and abutment. For individuals who grind their teeth, wearing a custom-fitted night guard mitigates excessive forces that could compromise the implant’s stability.
The Replacement Procedure
When an implant fixture fails, replacement begins with surgical removal of the non-integrated or infected implant. The surgeon extracts the failed fixture and cleans the site to eliminate infected tissue. Bone loss is a common result of failure, especially from peri-implantitis, so the site often requires a bone graft to rebuild volume and density.
The patient undergoes a healing period, lasting several months, allowing the bone graft to integrate and create a stable foundation. Once the site is healed and bone quality is confirmed, a new implant can be placed. This staged approach addresses the underlying issues that caused the initial failure, increasing the likelihood of success for the replacement implant.