A dental implant is designed to be a permanent tooth replacement, structured like a natural tooth with three main parts. The fixture, or post, is the titanium screw surgically placed into the jawbone to act as the artificial root. Connecting to this fixture is the abutment, which serves as the connector piece. The crown is the visible, tooth-shaped restoration that attaches to the abutment, completing the restoration. Any movement signals a mechanical or biological failure that requires immediate professional attention.
Identifying the Source of Looseness
The first step in understanding the issue is to determine which of the three components is causing the movement. The crown is the easiest component to identify, as it is the visible part that may feel wobbly or shift when touched. If the crown is the only part moving, it may have simply detached from the abutment due to failure of the dental cement or loosening of the retention screw. This is the least complex issue to resolve.
The abutment, the connector piece beneath the crown, can also become loose due to mechanical stress. If the crown is stable but the entire structure beneath it moves, the abutment screw may have loosened or fractured. This instability requires a dentist to access and tighten the internal screw.
The most serious scenario is when the implant fixture itself, the titanium post embedded in the jawbone, feels loose. Movement of this post indicates a failure of osseointegration or substantial bone loss around the device. This signals a biological failure that compromises the foundation of the restoration.
Common Causes of Instability
Instability in a dental implant stems from two broad categories: biological issues affecting the surrounding tissue or mechanical problems with the hardware. The most common biological reason for fixture failure is peri-implantitis, a destructive inflammatory condition akin to gum disease. This condition is caused by a bacterial infection that destroys the soft tissue and alveolar bone supporting the implant. The accumulated bacteria cause inflammation and progressive bone loss around the implant post. The risk of this infection increases with poor oral hygiene, smoking, and systemic conditions like uncontrolled diabetes.
Mechanical failure involves issues with the hardware components rather than the body’s response. The abutment screw can loosen over time, often due to excessive biting forces, such as bruxism (teeth grinding). This constant mechanical overload can also lead to the fracture of the screw or the crown, creating movement.
Another form of biological failure is a lack of proper osseointegration, which occurs if the jawbone never fully fuses to the post. This is more common in the initial months after placement, particularly if the patient has insufficient bone density or conditions that impair healing. If the implant has been in place for years, the looseness is more likely a consequence of peri-implantitis or component fatigue.
Immediate Action Steps
If an implant feels loose, contact a dental professional immediately; the issue will not resolve on its own. While a loose crown is less urgent than a loose fixture, all movement must be evaluated promptly to prevent further damage or infection. The dental office can determine the severity and schedule an appointment, often treating it as an urgent concern.
Until the appointment, avoid applying any pressure to the affected area. Restrict the diet to soft foods and consciously chew only on the opposite side of the mouth. Manipulating the implant, attempting to tighten it, or using over-the-counter adhesives must be avoided, as this can cause permanent damage.
Maintaining gentle but thorough hygiene is necessary to prevent any existing infection from worsening. Continue to brush carefully around the implant site; a warm salt water rinse can help keep the area clean and reduce minor inflammation. If the crown or abutment detaches completely, keep it clean and bring it to the dentist at the time of the visit.
Professional Treatment Options
The professional resolution of a loose implant begins with a thorough diagnosis, involving a clinical examination and diagnostic imaging. The dentist will use X-rays or CT scans to assess the bone level around the fixture and inspect the integrity of the internal components. This imaging is necessary to distinguish between mechanical failure, which is often simple, and biological failure, which is more complex.
If the looseness is mechanical, the fix is often straightforward, such as accessing and tightening the abutment screw to the manufacturer’s specifications. If the screw is fractured or the crown is damaged, the dentist will replace the faulty component to restore stability. These adjustments typically have excellent long-term outcomes, restoring the implant to full function.
When the diagnosis confirms biological failure (peri-implantitis), treatment focuses on infection control and tissue regeneration. Non-surgical therapy involves specialized deep cleaning (debridement) to remove bacterial plaque and calculus, followed by the application of topical or systemic antibiotics. In advanced cases of bone loss, surgical intervention may be required, including flap surgery and bone grafting. If the implant fixture is mobile, it may need to be surgically removed, requiring the area to heal before a new implant can be placed.