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Print This PostPlaced a dental implant and it was type one bone, no pain for two weeks and then intense pain. The dental implant was surrounded by granulation tissue and no pus. The site was difficult to get numb and very inflamed. Thought it was an isolated case and then five more. Has anyone seen this?
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Thu August 07 2008
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56 Responses to “ Dental Implant Failure ”
I already had the same type of problem; one of the most common source of implant rejection in type I bone is overheating of the bone during implant site prep.
In those cases, cleaning of the site and a healing period of 12 weeks and then reimplantation might be your answer.
take no risk , use brand new drills and overcopious cold irrigation.
best regards
Speaking of cold irrigation…..do you think many people refrigerate their saline solutions.
Are people doing both internal as well as external irrigation?
I also think that disposiable drills would be a great thing for the companies to provide.
sounds like you’re burning the bone.
copious irrigation is great but don’t be spinning around in there. in and out, next bur one sraight motion like a drill press.
There is a study by M. Sharaway and c. Mish coming out that shows that internal or external irrigation doesn’t matter much as long as you use refrigerated water for cooling
What about drill speed because I remember that the thoughts about slower may not be the case. I have heard about internal verses external no difference. Nobel Phar was external in the beginnig and Bicon…..no irrigation just very slow. Great idea about the refrigerator
You’re perfectly right. There is some new evidence that higher speeds rather than low are more indicated
Overheating is always a potential problem. Copious irrigation, sharp drills, and RPM up to 2500 helps in type 1 bone. Over tightening the implant above 45 NCM can cause pressure necrosis beyond tollerable limits. The other concern is micromovement of the implant by the patient. Exposed abutments reduce percentage of success and a patient can even get micomovment with chewing when an implant is covered. Check the patients habits the best you can. Good luck.
I believe that there is not enough discussion about pressure necrosis and I think it is a real issue. There was a time that I thought osteotomes was the best way to deal with bone in the maxilla, type 2 and 3 but now I am thinking that bone compaction using osteotomes leads to pressure necrosis.
The use of the Nobel torque wench really help with not over tightening the implant at placement.
menstion pr. necrosis I can imagine this in max.but not in type 1 bone,it is not easy to compact a compact bone.what you got is crack necrosis.
who can help me with this problem. My wife has dental implants of 3 upper front teeth finished in 2002. she had a bone graft from her jaw to replace bone lost during the 10 years since she lost her teeth and had worn a dental appliance until 2002. the first bone graft failed and exposed the front of her gums and implant posts, she had cadaver bone implanted with a new procedure that also injects red blood cells to increase blood flowto the area. as of febraury of this year and already seems to be losing what was recently implanted. some of her bone is exposed and bone is being forced out from around her implants. (we understand that some is will occur) the Oral surgeon has suggested that the only other way of stopping this is to harvest bone from her hip. what options are now available to stop the bone loss and or options as to slowing the rejection? she really wants to keep her implants.
i use individual irrigation for each surgery and with cold serum and not more than 900 rpm and i use a trispade bur for the first cut. i use a pressure pump to the irrigation with all disposable material. I have some failed implants and i found the reason my motor was basculating the burs just a litle it is suficient for incresing the temperature. the type of surface is important and if is blasted whith aluminium the provider must wash very well the implants some companys (…) well it is better titanium blasted implants..
My question is concerning my mother. She went to a dentist who was making her a crown ( insert post and false tooth)…The tooth wasn’t the correct size and since other dentist said the post was crooked….she has now had a bone graph by another dentist for an implant which should be put on possibly next month. My question is that every since the first dentist worked on her she developed a sore in the roof of her mouth just behind the two front teeth. The 1st dentist was concerned about the color of the tooth and had his onsite lab put a chemical on her tooth after it was already attached. This bothersome sore has been there for now 8 months. One dentist pulled the skin back and cleaned it. The sore will not go away. My mother is concerned it could be oral cancer but no one has taken a biopsy….what do you make of this sore. FYI…she has been to several different dentists over the past 8 months….
I had an implant almost 3 years ago. There was significant bone loss, so a bone graft was done after the first year. The loss coninued, with pain upon biting down. Both dentist and surgeon insisted pain was not possible, called it “phantom”. I insisted, surgeon felt it was neighboring tooth, and blamed failure on occlusion. Dentist contiued to adjust tooth above, even though he disagreed. Surgeon says wait till it fails to remove because it’s so close the the nerve, bottom jaw. Finally, yesterday, my dentist believed it was pain at the implant site when he did some testing and had me bite down on a stick, and saw it hurt. but no solution, “if the pain gets worse come in, or maybe remove the top piece to avoid bearing pressure. Please, there must be something that is missing here, and can be done! The surgeon supposedly had a 100% success rate, prior, and can’t see any causes in his proceedure.
What brand of implant are you using? I have had some serios issues with 3i.
I had just, this morning, had a crown put in place in the last stage of a dental implant. I had the titanium post put in about 5 months ago and there was no problem — everything healed really well. When the dentist placed the crown on the post this morning, it was very tight and he filed it down (or whatever is done) and fitted it. It was still very tight but he said it would settle in after a day or so. I notice that it hurts when I bite down. Will that go away after a day or so too? Is it common to have pain when you bite down the first day? This has been a long and expensive process and I hope that everything is all right.
I started dental impant procedure for a full uppers.
My dentist did the right side (5 implants) one month ago. Since then 1 healing screw which was exposed lossened and now he telling me another has lossen. What is the cause? He removed the first one, do he have to remove the second or tighten it.
Does anyone have any thoughts about Straumann ITI’s new surface and the effect that it could have on implant failures. I understand that it is chemically active and shortens healing time to 3-4 weeks. It has not been released yet. I am looking into it. Any feedback would be greatly appreciated. Thanks.
In implantology,pain after crown placement can be caused by several factors, from pressure to the adjacent tooth and their periodontal ligment to problems with implant osseointegration. If it doesn´t desappear in a couple days (the period need for periodontal fibers readaptation)
you should visit you dentist again and consider some kind of osseointegration failure.
I just had my implant removed due to osseointegration failure can anyone point to the possibility of a correlation between this failure and rhumetiod arthritis?
I had a bone graph seven days ago and the stitches were removed today, the gum did not cover the opening at all there is a large area of bone showing and I’m in pain all the time, does anyone have any suggestions?
I wonder how many of the above with implant problems were taking a bisphosphonate???
Can anyone tell me if you should feel anything during osseointegration? I mean is it normal to feel a little stinging in the implant site?
Pain is not normal after several weeks of skin healing. If pain is present call your dentist immediately.
I have developed a nagging headeache 1 one month after bovine graft and titanium implant. I have never had headeaches before. Had this one for over two weeks. Could this be related to implant procedure?
I had an extraction along with a bone graph 1 week ago. I have been in excruciating pain since-I was told I may have a dry socket(I have had one before so I am familiar with that pain). My surrounding teeth are painful as well and I can taste infection. I have left messages today for him to take this bone graph out. Has anyone heard of bioase grpahing material causing such failure?
In type one bone, overheating is an important cause of failure, especially with very long fixtures. I don’t believe refrigerated coolant is necessary, but “it couldn’t hurt.” As far as internal vs external irrigation is concerned, I prefer external, and never use internal. When drilling in dense bone, it is important to keep the drill rpm at the 2000-2500 range. This gives the opportunity for the drill to cut with less pressure than a slowly turning drill. Slow rpm, higher pressure and longer drilling time, with whatever type of irrigation you prefer, will burn bone. It is important to keep the drill spinning 2000 prm and to pump it straight up and down with light to moderate pressure to allow fresh coolant to enter the osteotomy. When drilling the osteotomy in dense bone, you need to get in and get out. Time and pressure, even with irrigation, kills bone. In dense bone, the internal irrigation hole often gets clogged, making the external irrigation the most important.
I would love to know from the dentists reportng failures and from the patients reporting problems if any of the patients are on Fosamax or Actinel.
I have been on Actonel for 2 yrs. and had an implant #19 with a bone graft during this time frame. I ache constantly in my left jaw. I have had extensive occlusal adjustments to no avail.I am thinking of going off the Actonel.
“I find that primary fixation is the most important thing to obtain in implant success. This view comes from the work of the graftless folks in Europe including Rangert. I have found that when the torque insertion exceeds about 60NCM I will see bone loss and/or loss of implants. Certainly as you increase insertion torque to very high levels such as 75-100NCM, a level that takes a lot of force, implants are lost. This has happenened to me a couple of times where the implant could not be backed out (strauman) but could be advanced and taping was not done adequately in denser bone. Tap and retap or remove the implant and re-drill. If high torque is required. It is better to abort the procedure and delay polaement three weeks. The implant can be placed then. Watch out for this phenomena when HA augmentations have been done previously and now implants are to be placed. Osseous trauma in the Bisphosphonate patient should especially be avoided. I use a transgingival approach on the fosamax patient whenever possible.”
Ole Jensen
One thing that was not mentioned - was there bleeding in the osteotomy prior to implant placement? If there is no bleeding, there is very little cellular component to the walls of the osteotomy and extremely unlikely to get integration. It has VERY LITTLE to do with the potential of overheating of bone. Most osteotomies are drilled well within the proscribed limit of time/temperature. Also, drilling at lower rpm will likely cause chatter while drilling which results in an eccentric osteotomy. This will epithelialize BEFORE bone will grow by distance osteogenesis resulting in fibrous encapsulation.
Has anyone gotten a zirconium dental implant? Did it take? Can zirconium dental implants be placed in the USA? Which is the best zirconian dental implant at the moment, and is any implant manufactuer planning to market a zirconium implant in the near future in the US?
I had a dental implant placed 2 weeks ago on lower right side (8 months after bone graft healing). Today the implant site is still throbbing. I went back to surgeon for new medication, thinking it may be infection, but still no relief. Surgeon was very careful (because of proximity to nerve). He drilled, then stopped, x-rayed, came back 15 minutes later, drilled, stopped, x-rayed, came back 15 minutes later, drilled a final time, then placed an 8 mm length vs 9-1/2 mm due to proximity to nerve. Before surgery I told surgeon I didn’t want the procedure done if he was not confident about placement. He said he has CT scan and is extremely confident, but as a precaution, he would drill take xray, drill again, take xray to make sure he is in right position. I was in his chair for almost 3 hours while he visited other patients in between drills….is it possible the bone was open too long? or too many re-entries with drill? What should I do? I take a pain killer in afternoon when I can no longer stand the throbbing, but after 2 weeks I can’t bare it.
Does any one recommend one particular implant company over another, and if so why?
I am currently researching different loupe companies. Does any one have a prefference of one over another and why?
Can anyone tell me if the top of the screw head that you can see is supposed to be covered by anything or are you suppose to see screw? My top implant keeps coming lose and I think it may be because the Dentist didn’t place something between the screw and the chewing surface. Please advise?
I recently has a case that I placed an implant six weeks after extraction of 41, primary stability is good and surrounded all round by bone. After 3 weeks, patient developed abscess on labial and there is severe loss of labial bone with the other sides intact. Implant still stable. What could be the cause. Anyone has the answer…
Can anyone explain about problems caused by possible oxygen starvation to the implant site and also any links with facial palsy,or continued numbness after the proceedure?
I am a healthy 48 year old. Yesterday I had a baby tooth extracted and an implant was put in place. I am in no pain, and everything seemed to go well. This morning, my dentist called. When she reviewed the x-ray, she found that the implant was placed too close to another tooth. She wants to take out the implant, let the bone heal, then redo the implant. I am ready to tell her to just forget it, that I want a false tooth instead. Am I being too hasty? Also, the peiodontist who did the work was wearing neither a face mask nor a cap for her hair. Her hair kept falling into her eyes, and it was difficult for her to see. Is this normal?
Thanks for your help.
I am missing my upper right second to last molar, which was pulled almost 2 years ago(no wisdom tooth on that side). My dentist is telling me I have to either have an implant or a bridge put in. Aside from the dentist telling me it must be done, I have had no problems or complaints about not having that tooth. Is there any medical reason why I have to have something placed there or can I just leave it vacant? and for how long?
Dear Dr.s
Pleac inform me if there is any restriction to implant replacing congenitally missing upper laterals in 14 years old girl
with my thanks
I had sedation dentistry for a full upper and lower implantation, every single tooth. Since all was completed, I have had 2 root canals in molars. I have had the implants for approximately 1 year. Over the past 5 months, I am experiencing moderate to severe intermittent pain in what I believe is my upper front right and lower front right teeth. It hurts all the way down my neck and up into my forehead area. My dentist (who I really like) has said I do not have an absess or infection. He does not know the reason for the pain. Any ideas? (I had a friend who had 8 implants and she had the same type pain and had her implants removed.)
I had 4 implants put in eight months ago. Two on the upper right jaw, and two on the upper left jaw. The two on the upper left are longer implants. I am unable to chew food that is tough such as steak or harder bread. Oral Surgeon just says everything is fine. Had CT scan done and Ear Nose and Throat Doc advise me to see a Neurologist because the other pain I am feeling is tinglin in my adjacent teeth and upper area around the implant assume poosible nerve damage from too long of an implant.
I had an implant on my one front tooth. There was hardly any bone loss, but my surgeon did put very little bone in. Did the healing process. Went to the dentist to finish with the abutment and crown. Everything was fine until the abutment was put on, then there was severe throbbing pain. Then the crown that came in was not right. Way too big and as white as a chicklet. So he took it off and sent it in to be fixed. I asked the dentist if the abutment was the right size, he said yes there was only 2 sizes. It’s been a year and after xrays and no infection they were saying it was the tooth next to it. I KNOW which one hurts. The tooth next to it never had any problems and is fine. Now they say it is phantom pain. PLEASE help! The pain is not quite so severe as it was. Is there anything I can do or go see to aleviate this. OR do I have to live with it. They also suggested acupuncture. Could it be the removal of the temporary and the removal of the crown to replaced. There was a lot of pulling and tugging to get the chicklet crown off. Thank you
Please help me, I had a dental implant done in 1998. and a crown was put on. At the time of the implant, I kept telling my dentist that it ached and we took xrays and their was no apparent problem. it took many years for the pain to subside and my tooth felt loose when I would floss, I also mentioned this,to no avail nothing was done. most recently I bit into something and the crown broke off. I went to a specialist for dental implants and he informed me the type of implant I received in 1998 is no longer made by the company, because their was problems with it coming loose. My point exactly, I kept saying their was a problem, no-one would believe me. So now I am suppose to pay to have this whole process done again. I think I should hire an attorney and go back on this company for suppling faulty parts. Has any-one had a simular expereience? Please let me know. Thank you.
Hi, I just got back from dental implant consultation for my two front teeth. There is a lot of bone loss and the dentist informed me that a bone graft is needed but the success rate for “front” bone graft is not very good and is infact an extremely difficult procedure. He gave another option of “augmenting the bone with synthetic material” and just improving my current bridge, this way the problem of bone loss (w/c is not very pleasant to the eye is solved). I am not very sure w/c option to take 1. dental implant or 2. just bone augmentation. Please help.
There are parts available in the marketplace for many implants that are not currently being manufactured. It is likely that this situation will manifest itself again if it happened once. Get all the info. you can about the implant from your practitioner and do some research for parts that may be available. Although you may not be able to order your parts you could ask your Dr. to do so.
I have had tooth implants for my two front teeth. The first and second procedure went well. When they placed the crowns on, I began to feel pain. My head has been throbbing and wakes me up. I am wondering if anyone else was left with throbbing pain?
I had my #8 tooth removed and bone graph done at the site in preparation for a permanent three tooth bridge. I’ve been told that the adjacent tooth next to the #8 tooth has been compromised due to a root canal on this tooth. I have decided to go along with the bridge instead of an implant on the #8 tooth. I’ve been told by a periodontist that the bridge is going to put more unwanted pressure on the adjacent root canaled tooth(compromised) which could cause me problems with this tooth in the near future. Have I made the best decision? Would the dental implant be a better choice for the #8 tooth?
i have had a second round of implants done this week . Of the prvious , one (#10)became infected immediately and was removed after 3=-4 weeks . One of my new implants now feels infected 1 week after insertion . Q Is ther any successful treatment for the infection short of removing the implant ? Any site specific treatment? thanks
Can ANYONE who KNOWS ANYTHING about the complications of LOADING dental implants please help me!!! I had 2 implants placed with cover screws nearly a year ago.Six mo. after placing, I was sent to the prosthodontist for the placement of abutments and fitting of crowns.Immed. upon leaving his office with the abutments and temps, I developed a SEVERE BONE TYPE OF PAIN. This is a SPREADING sort of pain that goes into my mandibular muscles and cervical muscles on the same side.The implants were placed into the mandible, #19 and 20.WHY AM I IN SO MUCH CONTINUOUS PAIN SINCE THIS APPT? I WAS IN NO PAIN PRIOR; EXCEPT FOR A ONCE IN A WHILE FLINCH THAT DID NOT TAKE ANY SORT OF MY ATTENTION. THANKS!!!
dear Kimberly,unfortunately the information you give us is very little and incomplete for anyone to be able to answer your questions responsibly.Ill ask you some questions to get a clearer picture.1)are u sure u didnt have any symptoms prior to the placement of the abutments?2)did your prosthobontist torque the abutments on your implants(this means if he screwed them in place using some kind of mechanical or electrical instument).3)if he did,did your pain start immediately after that?4)if i understood you correctly he put some temporary crowns on top of the abutments.does your mouth close correctly after that or do you feel primary contacts(meaning if you feel that the temporary crowns hit the opposite teeth first,hinderinf the rest of the teeth to touch like they used to.and 5)did you complain to your prosthodontist about the symptoms you have? i am looking forward to your answer and will be checking in legurarly,hoping that with the info you will give us we will be able to help you.take care
Can any one tell me if you can reject an implant.
I had two place 6 months ago which failed and had to be removed after 8 weeks. I just had 4 new implants done last month and have lost 2 already. They start to ache then hurt then pop out. One came out with the adhesive in my denture which I could not wear for the first 3 weeks. I had no signs of infection and was treated pre and post implant the second time. I had a real problem with swelling and ulceration of the gums around the implants both time despite strict oral care.
My experience with implants and questions. I went through a lot of prep to get implants. I had had a bridge for 18 years and the underlying bone had receded so there was not enough of a base for an implant. I had a bone graft and several soft tissue grafts. Prior to the implant I had a CT scan to verify that there was enough material to put the two implants in 8 & 9. I am writing here so things did not go as expected. My questions are as follows. I had a nasty infection above the implant and want to understand possible reasons. It was not at the gum line. It was very painful and was lanced with positive results along with a whack of antibiotics. Could this have triggered a rejection of the implants? Second, I work with a lot of machinery and tend to believe that slow cutting drill bit would expose healthier tissue for the implant to form a bond with, burning a high rpm when drilling seems like it would only traumatize the surrounding bone and force rejection. HAs anyone ever looked into this. Also if you are either sick, under stress or experience an infection, or in my case all three, is it likely to slow the healing process to the point where the body is forced to reject the implant? I have had a bone graft to fill the areas where the implants were and am working with my periodontist to try again in several months. Does anyone have advice to ensure success the second time. If it fails I will revert back to a bridge. One last thing, if it failed once, what is the likelihood of it happening again?
Thanks you for your help
I just had two dental implants done replacing #29 and #30…as soon as the novacaine wore off the throbbing in my #28 became unbearable…upon taking an xray my general dentist said that the oral surgeon had placed the implant way too close to #28 and more than likely i will now need a root canal on #28…i am in constant pain from my jaw up to my ear and even into my sinuses..i am thinking of having the implant removed instead of having root canal on #28 because aside from deadening #28 what else will the root canal accomplish?..there will still be the pressure and inflammation but i just won’t feel it..i am truly sorry i had this procedure done at all…
I had four teeth replaced 14 years ago…bone graft from my hip…these are the best teeth on earth! I thank God daily for this wonderful dental technique. The expense was huge but the benefits are wonderful.
I feel the type of implant may play a role in failures.
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