Bone Deteriorating Around Dental Implant

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Stanley, a dental implant patient from NY, asks:

I had dental implants placed across my entire upper jaw about eighteen months ago. Everything went smoothly. Recently, however, I went to my dentist and after taking a few x-rays, he told me that the bone around one of my implants was deteriorating rapidly. The dentist had never seen this before and I was told that I need to immediately remove this dental implant and have another one placed to preven the bone loss from spreading.

However, I am concerned. Why would bone deteriorate around the implant? What is causing this? Is removing the dental implant the best option? How would bone deterioration be prevented in the next implant? In case it matters for an answer, I was told that the dental implants used in this case are Straumann implants.

Thanks for any information you can provide.

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11 Responses to “ Bone Deteriorating Around Dental Implant ”

• Dr. Brad April 3rd, 2007

  
  

  need much more information to answer your questions. Your correct in being cautious. Find out a true diagnosis before retreating.

• Dr. M April 3rd, 2007

  
  

  Bone loss around implants and/or teeth does not “spread” unless what has caused the problem exists in other areas also. Without more details, implant failure after osteointegration is due to poor hygiene or overloading.

• Jane April 4th, 2007

  
  

  could this bone loss be due to a microgap bacterial concern???

• Dale April 4th, 2007

  
  

  Stan, we need more information to answer your question. Were the implants splinted? Is there an occlusal interference (overloading) problem on this implant? Was the bone volume adequate at the time this particular implant was placed? To many variables to pin point your problem. This cannot be determined without an exam.

• Stanley April 4th, 2007

  
  

  Hi there,
  Thanks very much for your responses. I will ask my dentist for more information and post it. But, first, can you please explain what you mean by “overloading” and “splinted”? Thanks.

• Harold Bergman April 4th, 2007

  
  

  I have been placing and restoring implants for 40 years. I recently have had 3 cases with widespread bone loss over 6 to 8 implants with a bar overdenture. I agree with the above comments. However If the patient has a history of periodontal disease, smoking, diabetes, high blood sugar, drug use, some medications such as the biphosphenates, etc., expect problems such as this. I am beginning to think that we rarely have the opportunity to place implants into a perfectly healthy patient. There is always some degree of health problem. I think we need to start thinking about how we get away with what we do in the mouth rather than expecting every case to be a miracle and inform the patient, we are going to have problems.

  Harold Bergman

• CatScann April 10th, 2007

  
  

  Need more information. Overloading could be the culprit. I have seen cases where residual cement was the problem. Perhaps it was placed in a site that needed grafting. The microgap is not the cause of rapid bone loss. Once the implant integrates start to look at prosthetic issues.

  Too little info to diagnose…sorry

• Don Callan April 11th, 2007

  
  

  First, the bone loss about one implant will not cause bone loss about the other implants. The other respones above are correct, we need more infprmation. There are a number factors that may help the bone loss to get worse, but the number cause of tooth loss is bacterial. The number one cause of bone loss and implant loss after loading is also bacterial. I would look at the location microgap, it be the main cause.

• dr. Micki Gelb April 12th, 2007

  
  

  The real cause of causes is the powerful gravity, than insufficiently balanced restoration in a diminished intra-oral space, ill tongue posture, certain premature occlusial contact, bone loss, gap development and only after all of this pore hygiene and infection.
  Can it spread? It may. It depends on degree of gravity satisfaction.
  For prevention of this kind of complications every implant case need to be prepared before loading with restorations.

• Dr.Mehdi Jafari April 12th, 2007

  
  

  Trauma from Surgery ( e.g. Periosteal Reflection)
  Smoking
  Hormonal Disorders
  High C/I Ratio
  Low Bone Quality or Lesser Bone Density (D3 & D4)
  Dynamic Load versus Static Load (Loose abutments or ill fitting restorations)
  Fixtures with close proximity to Cantilevers
  Occlusal Trauma (Overload or Biomechanical Stress)
  Establishment of an increased Biologic Width.(normal 2mm epi. &1.5mm conn.)
  Plaque Accumulation and Bacterial Invasion
  Level of Microgap between Abutment and Fixture
  Autoimmune Response and Cytokine Release (Controversial)
  Crushing of Marginal Bone and Microfractures due to Installation Stress of Self -Tapping Implants.
  Not enough space between two implants or/ an implant and natural tooth.
  IMPLANT DESIGN : ( Crestal Modul not Divergnt and/or Polished Collar)
  These are all causes of bone loss around implant necks.Check it out.

• Dr. Gerald Rudick, Montreal April 13th, 2007

  
  

  Comment to Harold Bergman;

  I have been placing implants almost as long as yourself, and occasionally am surprized and disappointed in what seemed to be an ideal case gone bad.

  I am starting to believe that granulomatous cells that may have developed due to an endodontic infection, periodontal disease,etc…may remain dormant for a time and then come to haunt us again.

  Meticulous scraping, cleaning the site with citric acid and antibiotics,grafting, etc., may seem to help in the short run, but I do not believe there is any literature support the fact that 100% debridement is possible.

  We try to do everything correctly by following the known protocols, but you never know what is in store for the future with the current solutions we have to solve these problems.

  Don’t feel bad Harold, you are doing your best and you are doing a good job; but none of us are Gods.

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