DENTAL IMPLANT COMPLICATIONS


The purpose of this page is to inform you about the potential complications and how they can be prevented and treated. We believe that our patients should know EVERYTHING. A knowledgeable patient is stronger, because they understand and willfully take on habits which constitute key factors in the healing process. Do not hesitate to ask us about any aspect of the treatment you may find not clear enough. Also, please keep us informed with respect to any event following the implant. We have a 24/7 number where you can talk to someone in the staff who is familiar with your case.


SWELLING AND BRUISING ARE COMMON DENTAL IMPLANT COMPLICATIONS

Following the insertion of the implant, sinus lift and bone graft (depending on the span of the procedure), it’s not uncommon to see swelling and bruising. They pose no risks to the implant and generally don’t require special medication in addition to the one recommended by your doctor. They will go away in a few days after surgery; with the mention that they can occur on the first three days if of the medication was not administered.


PAIN – DENTAL IMPLANT COMPLICATIONS

Post-operative pain is inexistent in 95% of the cases. Provided that you follow our advice. Pain control is the same as with every other type of surgery, which is a combination of pain killers and anti-inflammatory drugs immediately after surgery.

INFECTIONS - DENTAL IMPLANT COMPLICATIONS

The risk of infections is very high if antibiotic treatment is lacking. In case of sinus surgery, a combination of a strong antibiotic and a nasal decongestionant is mandatory to avoid sinusitis. You must avoid putting pressure on the sinuses, so avoid blowing your nose, sneeze with your mouth closed and drinking through a straw.

WOUND DEHISCENCE AFTER SURGERY

It is an opening of the wound before it is completely healed. It does not lead to surgery failure, but it does require increased care by applying special gels and rinsing your mouth with disinfectant solutions and antibiotic treatments. The evolution is successful in almost 90% of the cases. Of the systemic factors which might influence healing, some are diabetes which leads to a reduced tissue perfusion and low immune response. We do NOT perform surgery on patients who neglect their treatment or cannot control their blood sugar level.


FACTORS WHICH INFLUENCE THE HEALING OF THE SURGICAL WOUND

TISSUE INFLAMMATION AND HEALING

Healing is influenced by local and systemic factors.

Gum inflammation and diseases have a negative effect on the healing. The procedures must be performed as long as there is no inflammation. Any cause must be eliminated by the hygienist, but also the patient must be informed regarding a correct hygiene at home before and after microsurgery.

Removal of plaque and other residue in the oral cavity are mandatory before surgery.

Microsurgery procedures determine a more efficient healing, with atraumatic and precision treatment. Immunosuppressant such as cytostatic and corticosteroids weaken the immune response and delay healing. Keeping a strict hygiene is paramount.

AGE CAN INFLUENCE HEALING

Studies have shown that young people recover faster. Since so many factors contribute to the healing process, a good general health is essential.

DENTAL IMPLANT COMPLICATIONS – PERIIMPLANTITIS

A dental implant does not rust and is immune to cavities, but can it can develop periimplantitis which is the inflammation of the gums or the bone around it, which untreated, can eventually lead to bone loss and even implant loss. Periimplantitis is curable! In most cases, it affects heavy smokers (over a pack a day), diabetics with constantly high sugar levels and patients with poor dental hygiene.

SURGERY WOUND HEALING AT SMOKERS

Smoking has always been associated with several diseases of the oral cavity, such as periodontic disease, bone retraction, tooth loss and implant failure.

The impact of smoking over wound healing is determined by the effects of nicotine and secondary substances at cellular and systemic level. Smoking causes vasoconstriction of the veins inside the gums, reducing the blood intake and healing and slowing down the flow of oxygen into the wound.

In conclusion, smoking delays healing, increases the risk of dental implant complications and reduces the body’s response in qualitative and quantitative recovery of the jaw bones.

DENTAL IMPLANT COMPLICATIONS – IMPLANT FAILURE

The causes of implant rejection can be unknown and impossible to predict before surgery. The rate of success in our practice is 99,8% for primary integration, which is exclusively dependent on local factors and compatibility with the receiving body. The most serious complication is rejection of the dental implant. The cause of such scenario is not intolerance to titanium, but a local factor (most likely) or a general unidentified factor. After a thorough investigation of all possible factors and taking proper measures, the implant is reinserted. The initial failure can be turned into a late success.

GUIDED BONE REGENERATION

Guided bone regeneration (augmentation) is a sum of techniques (dental microsurgery, piezosurgery) whose purpose is to increase the size of the jaw bone. It requires thorough and precise dental surgery. Guided bone or tissue regeneration procedures are difficult procedures, but necessary in many cases.

The volume defect is corrected with the aid of the autogenous bone (the patient’s) combined with an artificial bone protected by a membrane (resorbable or not) which directs healing. This membrane is vital in protecting the newly formed bone from the invasion of cells from the adjacent soft tissues.

The rate of success with implants inserted in the regenerated bone is equal to the ones inserted in natural bone.

Dental extractions come with a certain degree of bone retraction. They can damage the bone if they are not performed through atraumatic procedures, which protect it.

GUIDED BONE REGENERATION-INDICATIONS

Before this type of surgery, we need a complex clinical exam, a panoramic x-ray, a 3D CT scan and a set of lab investigations.

While inspecting the edentatulous ridge, we look at the CT scan to determine height and width of the bone, in order to estimate the degree of bone regeneration we can obtain. The importance of maxillary CT scans in implantology is overwhelming, let alone the guided bone regeneration and periodontal.

Of great importance are information regarding the keratinization of the healed gums after extraction.

THE FUNDAMENTALS OF GUIDED BONE REGENERATION

The artificial bone and the barrier membrane are the essential factors in the regenerative process. In choosing the bone graft, it is considered that the autogenous bone is the most efficient in bone induction since it contains natural ostheogenic cells, but it is not stable. The artificial bone is a solution, since it is biocompatible, osteoconductive, similar in structure to the natural bone and bioresorbable. The artificial bone does not transform into human bone, but it is a matrix, a fertile ground for the development of future bone cells. The best results are reached when we combine autogenous bone with artificial bone. The former is harvested from the area where the procedure will be performed.

Applying a resorbable or unresorbable membrane isolates the graft from the bone and increases the chances of the implant to integrate in the newly formed bone. Bio-Gide and Jason Botiss collagen membranes are stable, well tolerated and perfectly resorbable. They have passed all our tests with flying colors.

RECOMMENDATIONS FOLLOWING GUIDED BONE REGENERATION

Healing must start under the protection of antibiotics, an hour before surgery and continue for 7 days after. Also, we recommend you take anti-inflammatories and pain killers to prevent swelling and pain. After surgery, a great remedy are chlorhexidine mouthwash and local healing and disinfectant gels. Be careful when rinsing your mouth. Don’t be harsh; just transfer the solution from one side of your mouth to the other for a few seconds.


A-PRF MEMBRANE IN DENTSTRY AND IMPLANTOLOGY

A-PRF is the a cutting edge method of obtaining healing membranes from Thrombocytes rich plasma and using them in dental surgical procedures.

A-PRF is a technology based on activating the patient’s own platelets to stimulate, regenerate and accelerate the healing of tissues. This technology encourages the body to use its own resources to heal, regenerating tissues with absolutely no side-effects. It significantly reduces the process of healing in cases of fracture, bone, muscle and tendon surgery.

A-PRF is basically enriched blood plasma, high in Thrombocytes. A-PRF contains many growth factors and cells which support and stimulate bone and soft tissue healing.

A-PRF is taken from the recently drawn blood, by separating the healing factors. The product thus obtained has the shape of a membrane or cork, depending on individual needs.

The growth factors in A-PRF are released gradually and their properties determine a fast recovery from the first days following surgery (primary phase).

By stimulating angiogenesis (the formation of new blood vessels) and implicitly the flow of nutritional and healing factors to the grafted area A-PRF plays an essential role in enforcing initial results.

A-PRF membrane can be mixed with the bone graft material in order to stimulate the adherence of cells on the biomaterials or on the titanium surface of dental implants.

The advantage that A-PRF holds over other techniques of concentrating the healing factors is that in obtaining the biomaterial, it only uses the patient’s own blood and nothing else..

At the Odonto-Med, we use A-PRF in sinus lift procedures (internal or external sinus), bone grafts, atraumatic extractions to preserve existing bone (prevents bone resorption), wound healing and periodontic surgery.

I-PRF

I-PRF is the procedure by which we obtain a fluid concentrated rich in platelets improved with white blood cells that contains multiple growing factors and other blood cells obtained by blood centrifugation.

The I-PRF concentrated is used combined with bone regeneration materials to stimulate the nutritional cell- aggregation on the materials to stimulate materials to stimulate the nutritional cell- aggregation on to the bone graft, the collagen membranes surface and the dental implants, also to obtain new blood vessles which will nourish and support the guided bone regeneration.