Complications and problems sometimes arising after dental implants

The authors | Last update: 2019

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Next you will learn:

What general complications after dental implants can await you on the way to restoring the ability to chew normally and smile beautifully;
What problems sometimes arise immediately at the time of the operation, and which some days, weeks, months, and even years after the installation of implants;
List of contraindications for implantation and their relationship with the development of dangerous complications;
How can you recognize the problem in time - what is considered a harmless side effect and what is a dangerous complication;
How to protect yourself as much as possible from possible troubles;
What types of implants are characterized by the lowest risk of complications;

... And also other nuances of practical interest regarding possible complications of dental implants.

Unfortunately, a person’s permanent teeth, in the event of their loss or serious damage, are not able to recover on their own and require artificial replacement, since a violation of the chewing function not only causes significant damage to the digestive system, but also negatively affects the quality of life in general. In order to return aesthetics and normal chewing of food, dentists already in the late XVIII - early XIX centuries began to use the first, then still primitive, dental implants made of wood, various metals, porcelain and other available materials. However, the very frequent complications after dental implantation operations forced doctors to constantly look for new technologies and more advanced materials suitable as implants.

Thanks to such continuous research and successful experiments of doctors who are advocates of dental implantation, already at the end of the last century this direction in dentistry has become one of the most popular and in demand among the general population. The most important result of such hard work was that the complications after dental implants ceased to be regular and expected., and dental surgeons have learned to one degree or another to minimize damage to health, even in the event of certain problems.

Currently, implant prosthetics is gradually replacing the “conventional” prosthetics, often requiring healthy teeth to be sharpened, or using partial or full removable dentures, which are often called “false jaws”.

However, is it possible today, when the 21st century is already in the yard, to say with full confidence that the complications after dental implants and the corresponding risks of problems during and after the operation have already completely receded into the distant past? Well, the answer here is quite clear, and, unfortunately, is negative - complications are still often encountered in the practice of implantologists. But why?

In connection with the proliferation of numerous implant systems, various implantation techniques and technologies, as well as the training of many hundreds of practicing maxillofacial surgeons in our country alone, at least 20 thousand implants are installed per year. And at the same time, the number of unsuccessful operations and negative reviews on the Internet is quite naturally increasing - problems can begin through the fault of an insufficiently qualified doctor, due to the choice of poor-quality implants (rarely, but it happens), and also through the fault of the patient himself at the dental clinic.

About how to minimize the risk of problems during dental implants, how to avoid the most common problem with implants - their “rejection”, as well as what to do if problems are nevertheless outlined - we’ll talk about all this in more detail ...

Complications that may arise during the dental implantation procedure itself

It is useful to keep in mind that some complications may arise directly during the dental implantation procedure, right on the dental chair. Moreover, the nature of the undesirable consequences may depend on whether an implant is installed on the upper or lower jaw.

The following is a short list of possible complications that may arise during the implantation procedure (in decreasing order of frequency of occurrence):

Severe bleeding;
Pain;
Perforation of the maxillary sinus and nasal cavity;
Damage to the wall of the mandibular canal and nerves of the lower jaw.

Let's look at these complications in order.

Heavy bleeding

During tooth implantation, slight bleeding is considered normal, and in most cases it is easily eliminated by conventional hemostatic techniques. Excessive bleeding can occur both through the fault of the doctor, and through the fault of the patient himself.

The strength of each person sitting in a dental chair to reduce the risks of developing this complication. Most often, bleeding from a wound occurs with an increase in blood pressure, as well as in violation of blood coagulability (taking drugs that "thin the blood", cardiovascular pathology, etc.).

Blood pressure monitoring, timely administration of drugs under the supervision of a cardiologist or therapist, proper medication and psychotherapeutic sedative (stress-relieving) preparation, as well as mandatory informing the implant dentist about existing diseases will help to avoid not only early bleeding during implantation, but also in a delayed period. The implementation of all recommendations after dental implantation, when a fresh wound is a zone of increased attention, is also of great importance for the prevention of complications, especially if more than 4-5 dental implants were installed in one day.

From the practice of the dentist

Bleeding due to the dentist’s fault occurs much less often than most people think (after all, what kind of thoughts can the patient have: “Well, I’ve cut my entire jaw, now the blood doesn’t stop, couldn’t it be more accurate to cut it ...”)

However, doctors who are just starting their activities in the field of dental implants and stuffing the first bumps, do sometimes sometimes experience unpleasant flaws in their work. However, even if errors are made during the surgical operation, not even an experienced surgeon can easily use modern hemostatic techniques and means to eliminate the negative consequences. Only wounding large vessels deep in the jaw, for example, with an improperly selected implant, can pose a threat to the patient’s life, but this is very, very rare (almost impossible).

Pain during dental implantation

Sometimes during the dental implantation procedure, quite strong painful sensations can occur, which, however, are usually easy to eliminate with an additional portion of anesthesia.

But in rare cases, it happens that anesthesia works badly. This is most often associated with the individual characteristics of a person. This situation is resolved simply: dental implants are performed under general anesthesia, in other words, when consciousness is turned off.

Therefore, if you are injected with an anesthetic, but the pain is still felt, you do not need to endure and be silent - you should definitely and immediately tell the doctor about it.

Perforation of the maxillary sinus and nasal cavity

Currently, this complication of implantation is much less common than before. Progress was largely due to the ability to accurately determine the distance to the abdominal masses using panoramic images and computed tomography (CT).

In order to reduce the risk of this complication to almost zero, you need to trust only an experienced doctor with a long record of work, and in case of doubt - consult with other implantologists. In the case of a close location of the maxillary sinus and the bottom of the nasal cavity, a “build-up" of the bone (sinus lift) can be previously performed, and then there are no problems.

The photo below shows an example of bone tissue extension before tooth implantation:

Damage to the wall of the mandibular canal and nerves of the lower jaw

This complication during dental implants does not always have long-term negative consequences, because, despite the frightening name, it actually manifests itself usually only as numbness in the lower jaw (most often the lips go numb). Even without treatment, these symptoms can disappear on their own within 2-3 weeks, with a maximum of 2-3 months.

In addition, it should be borne in mind that the feeling of numbness on the corresponding side of the face can also be a consequence of compression of the nerve in the mandibular canal. This sometimes occurs due to bleeding in the bone marrow spaces - blood can flow out not only towards the oral cavity, but also gradually move through the spaces of the bone, because the intraosseous tissue of the jaw is not “solid”, but cellular. The entry of even a relatively small amount of blood into the region of the passage of the mandibular nerve in the canal creates temporary compression. Gradually, the blood masses dissolve, but it takes time when the nerve recovers from such a compressive effect (usually no more than 5-7 days).

On a note

Complications such as a fracture of an instrument during surgery, a fracture of the wall of the alveolar bone, insufficient fixation of the implant, pushing it into the sinus of the upper jaw, etc., are even less common. The myth that a dental implant can get out of the eye or appear from the jaw through the cheek makes some people panicky about implantation. In fact, not a single doctor in his right mind will consciously harm your health using implants of the wrong length, and mindlessly screw them “all the way”. Therefore, this situation can be considered only from the point of view of popular horror films.

What complications sometimes arise after implant placement?

Complications after the installation of dental implants can be divided into the earliest, which manifest themselves within a few days after the operation, and later, arising in weeks, months, and sometimes years after implantation.

Early complications include:

Painful sensations;
Swelling;
Bleeding
Fever;
Seam discrepancy.

Generally speaking, pain is a normal reaction of the body in response to the traumatic intervention of a dentist-surgeon during dental implantation, and such pain appears after the end of the action of anesthesia.

Analgesics prescribed by the doctor usually effectively relieve pain, and the engraftment process does not bring too much discomfort to the patient. Normally, pain should not bother for longer than 2-3 days, during which time medication is indicated. If the expressed pain lasts longer - this is an alarming sign.

It is also useful to read: The use of mini-implants for fixing removable dentures

Soft tissue edema is the result of almost any surgical operation, including dental implants. Moderately expressed edema is a natural reaction of the body to injuries and "invasion", in general, of a foreign implant, and rarely lead to complications. Usually swelling of the tissues lasts no more than 5-7 days.

A possible complication in the form of an excessive increase in edema can be prevented by applying cold immediately to the face area where the implants were placed immediately after the operation.In this case, you should be careful and follow basic common sense so as not to cause frostbite and tissue necrosis (that is, comrades who just take something ice from the freezer, put it on their cheek and hold it for two hours - this is wrong and very dangerous) .

Weak bleeding in the area of dental implant placement can be observed within a couple of hours after implantation, when the vasoconstrictor effect of adrenaline added to the anesthetic ends. Even if such bleeding is delayed for a whole day - this is not a cause for concern. It is important in this case to distinguish between the sacrum (bloody fluid) from the strong and ongoing bleeding for more than 5-8 hours, which does not stop.

Important:

It should be remembered that a common cause of bleeding is the inattention of the person himself to the existing problems. For example, taking aspirin and several other drugs worsen blood coagulation, and high blood pressure prevents the formation of a clot in the wound; a number of diseases of the cardiovascular system make ineffective almost all home methods of stopping bleeding. It is important to always timely and correctly assess the scale of the problem and notify your doctor in advance of such nuances.

As for a slight increase in body temperature after implantation, this is also a completely normal reaction, which reflects one or another stage of the local inflammatory process after surgery. On the first day, the temperature can rise even to 38.0 ° C, but do not worry - the problem is solved with the help of antipyretic drugs, which is likely to be mentioned by the doctor himself.

However, if, say, closer to night, the temperature on the first day after implantation "exceeded" far beyond 38 degrees, and antipyretic drugs do not help, then it is advisable to call an ambulance, make a lytic mixture, and consult your dentist in the morning, as this may be a sign of complications after dental implants.

Most often, the temperature does not rise to such high values, but can stay in the range of 37.0-37.3 ° C for several days, which is a reaction of the body that is within normal limits.

Perhaps, it is also worth mentioning the divergence of sutures, often applied to the wound after implantation. The photo below shows an example of the normal state of the sutures immediately after surgery:

The divergence of sutures, as a complication, almost never is a sign of unsuccessful dental implants, since they more characterize the result of the behavior of the person himself. Violations can be very different: from non-observance of the principles of oral hygiene and ignoring the doctor’s recommendations, to unauthorized “tapping” in the oral cavity with fingers, toothpicks, etc., which leads either to mechanical damage to the sutures, or contributes to the onset of the inflammatory process. This provokes the divergence of seams in the future.

Late complications

Among the late complications that sometimes occur after a long period of time after dental implantation, the following can be distinguished:

Periimplantitis;
Implant rejection.

These complications can arise regardless of whether implants were installed on the upper or lower jaw, several or only one was placed, whether expensive implants were used or not. The risk of rejection and peri-implantitis (inflammation in the area of the implant) is always present, although, of course, quite certain factors influence the likelihood of such an unpleasant outcome.

Popular medical forums, which publish a lot of people's reviews on the results of dental implants, are often full of descriptions of various problems after seemingly successful implants. Moreover, violations associated with the "engraftment" of implants are usually among the first.

In fact, peri-implantitis and implant rejection are not as common today as one might think after reading the corresponding negative reviews. Each major clinic maintains official statistics on its unsuccessful cases, and the percentage of rejection from all registered implants is no more than 3-5%.

Moreover, often in such cases there are people who have been warned about the risks of rejection of dental implants in connection with existing contraindications, or who regularly violated recommendations for their care of prostheses on implants and had bad habits.

On a note

Periimplantitis is an inflammation of the tissues surrounding the implant. An infection that occurs when hygiene is not observed (most often), or if the implant installation technique is violated (extremely rare) can literally corrode the bone, leading to edema, suppuration, and severe pain. This complication is sometimes accompanied by the appearance of an unpleasant implant odor.

Further progression of peri-implantitis in case of failure to provide timely assistance leads to rejection of the implant - in such cases it is better to remove it immediately, without waiting until the inflammatory process leads to much more serious complications.

Rejection of the implant is often accompanied by its mobility and pain during exercise (when pressed). However, modern dentistry can sometimes solve even this, at first glance, the most terrible problem for many patients, a problem. However, we are not talking about the fact that the rejected implant will successfully take root after some manipulations by the doctor - no, it usually needs to be removed and re-implanted.

The photos below show the removed implants:

After removal of the movable implant, a complex preparation of the well for the next implantation is carried out, which can be carried out after 1-2 months. For example, with a significant decrease in bone tissue or proximity to the maxillary sinus, it may be necessary to build the jaw bone under the dental implant (sinus lift operation).

Indications and contraindications for dental implants and their relationship with possible complications

Indication for implantation is the absence of one or more teeth, as well as the impossibility of classical prosthetics. However, errors and complications when installing implants occur most often in those dentists who are guided to a greater degree by indications than by fully taking into account contraindications for implantation (sometimes this approach is due to commercial considerations, because no one wants to lose “expensive” patients).

Absolute contraindications for dental implantation:

Chronic diseases in a decompensated stage;
Severe hemostasis;
HIV and a number of other seropositive infections;
Some mental illnesses.

Relative contraindications:

Diseases in the acute stage, especially acute viral infections;
Chronic infectious diseases;
Condition after a heart attack and stroke;
Pregnancy and lactation;
The risk of bacteremia in patients with prosthetic heart valves after rheumatism or endocarditis;
Exacerbation of chronic forms of disease;
Conducting treatment with drugs that worsen tissue regeneration.

Relative contraindications give the doctor the right to postpone the dental implantation procedure. For example: after a full cure of a viral disease, a year after a heart attack, after breastfeeding, cessation of drugs that create risks of complications during and after implantation, etc., All this is necessary to minimize the risks of developing negative consequences implantation of teeth.

It is interesting

More recently, diabetes was an absolute contraindication to dental implantation. But at the moment it is proved that type 2 diabetes mellitus in the compensation stage does not affect the course of implantation and does not create risks of implant rejection.However, the operation is carried out under the strict supervision of an endocrinologist with mandatory monitoring of blood glucose levels (significant fluctuations in glucose levels are unacceptable).

Some people who, by all means want to get a beautiful smile as soon as possible after dental implants, sometimes have reasonable questions:

Or maybe you can still do dental implants during pregnancy?
And during an acute infectious process?

So, simultaneous removal and implantation of teeth during pregnancy can in some cases have serious negative consequences for the fetus, and it is difficult to imagine a situation where surgery is simply urgently needed. Better still wait. Pregnancy itself does not affect the process of “engraftment” of implants, but drug therapy, which is necessary after their installation, can have a negative effect on the developing fetus.

Even in case of an emergency, for example, an acute injury, which led to a fracture of the tooth or root and its subsequent removal, during pregnancy you should not rush with implantation. It is clear that the aesthetic problem that a young girl has can lead to stress and a nervous breakdown, but the health of the unborn child should come first.

As for implantation in acute infectious processes - due to the action of the infection, the body is weakened, and there is an increased risk of peri-implantitis when installing implants at this time. However, this does not mean that it is impossible to place implants in the well of a tooth removed due to exacerbation of chronic periodontitis of the tooth. Adequate drug therapy, proper selection of the system and technology of implantation can, of course, minimize the risks of complications even in such extreme cases, although it is generally unreasonable and dangerous to neglect contraindications, especially when this is done by a doctor only for commercial gain.

How to recognize the problem in time: from harmless side effects to dangerous complications

Despite the associated risks, a huge number of people all over the world put implants, get a Hollywood smile and the ability to chew food normally. As for the possible complications - someone is more lucky, someone less, but the positive effect of implantation directly depends not only on the professionalism and intuition of the dental surgeon, but also on the patient himself.

It is also useful to read: Which is better: dental bridge or implant?

The knowledge that allows you to recognize the problem in time and timely direct the situation to your advantage is not available to everyone. And if you rephrase a well-known saying, you get a kind of formula for a successful rehabilitation period after dental implantation: “Whoever owns the information knows the situation.”

Suspicious symptoms most often occur on the day of implantation or within 1-2 days after it.

Side effects can be observed even after jaw bone growth under the dental implant, which, however, does not always indicate the possibility of a dangerous complication. Sinus lifting is carried out with a good purpose, for example, to build up bone tissue near the bottom of the maxillary sinus so that it is not perforated during implant placement.

In general, bone grafting is almost always tolerated favorably, often it is performed simultaneously with the installation of an implant. But sometimes there are quite harmless side-effects of the time, disguised as complications that can frighten.

For instance:

Temperature increase up to 37.5 degrees;
A feeling of heaviness in the maxillary sinus;
Swelling of the face;
Small hematomas.

The fact is that the tissues of the maxillofacial region have abundant blood supply (especially the lower jaw), and almost any surgical intervention can be accompanied by phenomena that sometimes even inform informed patients.However, the frightening appearance of edema and hematomas in 90-95% of cases does not correspond to their real danger - that is, it all looks scary, but it is not dangerous to health and does not lead to serious complications.

A decrease in the severity of such edema and hematomas is observed already in the first days after implantation of the teeth (and sinus lift), and finally they usually disappear after 1-2 weeks.

In general, any surgical methods of dental implantation, as well as the stages of bone grafting, can not do without side effects, although in most cases it is not reasonable to consider them complications.

How to distinguish harmless symptoms that occur after dental implants from developing a dangerous complication? Here are a few examples:

Pain. As already noted above, this is a normal reaction of the body to traumatic intervention, as a rule, easily removed with painkillers. They are prescribed by the doctor after implantation of the teeth or sinus lift. But if severe pain accompanies healing more than 3 days from the moment of implantation, then a complication can be suspected.

Edema is also a common result of the inflammatory process, occurs 2-3 hours after the intervention. During the week, swelling of the maxillofacial region on their own pass. In case of their preservation after 7 days from the moment of implantation of teeth and, especially, with an increase in size, it is necessary to immediately consult a doctor.
Bleeding. Intensive bleeding within 8-10 hours after dental implantation most often indicates clotting disorders or problems in the cardiovascular system. If these basic reasons are excluded, then almost always the blood stops safely. The exceptions are injuries of large vessels made during implantation, but such complications are extremely rare and are manifested by severe bleeding, starting from the first day of surgery and more than 5-7 days with the formation of large hematomas.
Temperature rise. As well as after the sinus lift operation, an increase in body temperature even up to 37.5 within 2-3 days is normal. In rare cases, the temperature on the day of implant placement can rise to high values (above 38.5), especially after implantation of more than 6-8 dental implants, but this is not the result of complications or errors made during the operation, and in 90% of cases it is individual body reaction. A serious complication can be suspected if the temperature not only does not decrease within 3-4 days, but is also prone to some increase, and purulent discharge appears in the places of implant placement (pus may have an unpleasant odor).
Loss of sensitivity in the face. Loss of sensitivity in part of the face is a rather unpleasant, but not very often observed complication after dental implantation. Usually, decreased sensitivity lasts no more than 3-5 days. If during the implantation the dentist-surgeon suffered serious damage to the nerve, then its self-restoration sometimes ends only within 4-6 months. Recovery can be accelerated by physiotherapeutic methods of treatment and drug therapy, without surgical intervention.

Sometimes the appearance of an unpleasant putrefactive odor in the area of a recently installed tooth implant leads patients to think that a serious problem has arisen - it may be rejection, because “something is rotting and decomposing there ...”

In this case, it is useful to know a number of quite characteristic signs that really warn about the beginning of implant rejection:

Severe bleeding for more than 3-4 days;
An increase in edema and its preservation for more than 2-3 weeks;
Gradual intensification of pain within 2-3 days from the moment of dental implantation;
Sensation of “moving” a foreign body in the mouth where the implants were placed.

But as for the appearance of bad breath - everything is not so simple here.Such a smell can be caused both by the formation of pus (which may indicate a serious complication), and by the completely natural bacterial degradation of organics, sometimes even under the plug of an implant.

How to prevent negative consequences after implantation?

We note a number of simple rules, following which you can not only significantly reduce the risk of complications after dental implants, but also in some cases accelerate the process of implant engraftment, making it as comfortable as possible.

These are the rules:

Timely and correctly take the drugs recommended by your doctor (antibiotics, antihistamines, painkillers, etc.);
Responsibly approach mouthwashes with antiseptics;
Visually and by sensations, monitor the condition of the installed implants and look after them after implantation according to the scheme prescribed by the doctor;
Do not smoke at least 1-2 weeks after surgery (in some cases it is required to completely abandon this bad habit);
Limit chewing on the implant side (as indicated).

It should be borne in mind that only a dentist can choose for you an adequate course of taking drugs, based on your individual characteristics and concomitant diseases. Therefore, the independent choice of one or another home treatment method and drug may be fraught with undesirable consequences (for example, some comrades strive to spread gums with some ointments: Metrogil Denta, dental adhesive paste Solcoseryl or others, although this is not always desirable).

It's important to know

Until the seams are removed, the ideal food is boiled vegetables, light warm soups and fish dishes (boneless). But solid, sticky, floury, and especially sharp and hot dishes can contribute to the development of inflammation in the implant area.

After installing crowns and bridges on implants, it is important to carefully and regularly care for them. Twice a day, you need to brush your teeth and once - interdental spaces. Where the implant is in contact with the gum, it is recommended to clean it from plaque and food debris in the evening with a soft brush for interdental spaces.

Well, of course, the right choice of a dental clinic helps to avoid complications, taking into account the reviews of patients who have already visited it. In addition to the clinic itself, no less, and even more attention should be paid to the choice of a specific doctor who will perform the work, because the final result directly depends on his qualifications.

What implant systems are characterized by a minimal risk of complications

Currently, there are more than 300 types of dental implants, which differ from each other in many ways. However, among all this diversity there are no such implants that would be characterized by zero risk of developing possible complications after their installation.

Meanwhile, there are several really well-proven systems that are rarely rejected with the correct and professionally implemented implantation technology (and the relevant statistics confirm this well).

You can choose the safest implant system taking into account 5 main selection criteria:

It is highly desirable that the titanium of which the implant is made has a high degree of purification;
It is desirable that on the surface of the implant there should be both macro- and micro-threads;
The presence of a conical connection of the abutment and implant. The conical connection ("Morse cone") is currently one of the most reliable types of articulation and can extend the life of the implant;
Long-term manufacturer's warranty on the implant system. Some manufacturers give a lifetime guarantee on their products, which indicates the quality of materials tested over the years and the minimum risk of complications when working with similar products;
The life of the brand in the market. The longer the implant system exists in the dental market, the higher the chance of getting a really high-quality product.

At the moment, dental implants from Sweden, Switzerland and Israel have proven themselves to be the best on all these 5 criteria. At the same time, more and more cheap analogues of Asian origin from companies that have neither a long history nor sufficient experience in using their products have recently appeared. For the low price of dental implants using such analogues, there may be greater risks of complications, for which some clinics are far from always ready to bear responsibility.

Therefore, in order not to become the hero of the famous proverb “Avaricious pays twice”, you should be as responsible as possible in choosing a clinic, doctor, implant manufacturer company and going through the rehabilitation period after surgery. Then the result of dental implantation will be a really high-quality treatment without any unpleasant complications.

Be healthy!