Dental implants are small, threaded posts designed to replace missing tooth roots. They are surgically placed into the jawbone, providing a stable foundation for artificial teeth such as crowns, bridges, or dentures. While dental implants offer a durable and natural-looking solution for tooth loss, with success rates often exceeding 95%, instances of an implant coming out can occur. Understanding the appropriate steps to take and the underlying reasons for such an event can help individuals navigate this unexpected situation.
Immediate Steps to Take
If a dental implant comes out, remaining calm is important. Carefully retrieve the implant or any detached components, such as the crown or abutment. Handle the implant gently, avoiding contact with the root or screw portion, and rinse it with lukewarm water or saline solution without using cleaning agents. Place the recovered implant in a clean, safe container, possibly with milk to keep it moist, to preserve its integrity until a dental professional can examine it.
Contact your dental professional immediately; this is an emergency. Explain what happened, including any pain or symptoms. Avoid attempting to reattach the implant or any parts yourself, as this can introduce bacteria or cause further damage. Your dentist will provide specific instructions for interim care and schedule an emergency appointment to assess the situation thoroughly.
Common Reasons for Implant Failure
Several factors can lead to a dental implant coming out, often categorized as either early or late failures. Early failures typically occur within the first six months after placement, before the implant fully integrates with the bone. Late failures happen after initial integration and functionality have been established.
Peri-implantitis is a common cause of late implant failure, characterized by inflammation and infection of the gum tissue and bone surrounding the implant. This condition progresses from bacterial buildup due to inadequate oral hygiene, eventually leading to bone loss and potential implant mobility. Another reason for failure is failed osseointegration, where the implant does not adequately fuse with the jawbone. This can result from poor bone density, improper implant placement, or premature pressure on the implant.
Excessive biting forces, also known as occlusal overload, can also contribute to implant failure. This occurs when uneven bite alignment or chronic teeth grinding places undue stress on the implant, leading to bone loss around it. Poor bone quality or insufficient bone quantity in the jaw can hinder successful integration and stability, increasing the risk of implant failure. Mechanical failures, such as fractures of the implant components or loosening of the connecting screw, are additional reasons an implant may detach. These issues can arise from stress or wear and tear on the prosthetic parts.
Potential Health Repercussions
Failing to address a lost dental implant can lead to several oral health consequences. One significant concern is the progression of bone loss in the jaw. Without the implant to stimulate the bone, the jawbone can continue to deteriorate, potentially affecting the stability of adjacent teeth. This bone resorption can also alter facial structure over time, leading to a sunken appearance.
The loss of an implant can also cause adjacent teeth to shift out of their normal positions. This movement may create gaps or misalignments, impacting the overall bite. A compromised bite can lead to difficulty with chewing and speaking, as the remaining teeth may not meet correctly.
The visible gap can affect confidence and the appearance of the smile. The exposed implant site is susceptible to bacterial infection. Such infections can spread to surrounding tissues and potentially to other parts of the body, leading to serious health complications if left untreated.
Restorative Options
When a dental implant comes out, a dental professional will conduct a thorough assessment to determine the cause and the most suitable restorative option. This evaluation typically involves a clinical examination of the site, along with diagnostic imaging such as X-rays, to assess the condition of the jawbone and surrounding tissues. The goal is to understand the extent of any damage or bone loss.
If sufficient bone remains or can be regenerated, re-implantation may be a viable solution. For significant bone loss, bone grafting is often recommended to rebuild bone density and volume for a new implant. This involves transplanting bone material, which can take several months to heal and integrate. While often preferred, re-implantation may have a lower success rate than initial placement, sometimes requiring additional tissue grafts and longer healing.
Alternatively, if re-implantation is not feasible or desired, other tooth replacement options are available. A dental bridge can span the gap by anchoring artificial teeth to adjacent natural teeth. Removable partial dentures offer another solution, replacing missing teeth with a removable appliance. In some instances, after discussion, the decision might be made not to replace the tooth, especially if other solutions are not appropriate or desired.