Risks Associated With Dental Implant Surgery

It would be difficult to find a surgical procedure as successful as the placement of dental implants. Most studies estimate their success as being anywhere between 95 to 98% globally. That being said, the procedure does involve the use of high-speed drills in close proximity to a number of vital structures of the oral cavity. As with all surgical procedures, there are some inherent risks involved in an implant procedure.

Risks Associated With Implant Placement

Infection

This is by far the most common risk and one that is overlooked most often. It is very important the procedure is performed under aseptic conditions, with all the instruments being properly sterilized. Patients and dentists alike simply take this as a given, but reality shows that a high level of oversight and procedural competence is required to achieve good infection control.

There is nothing wrong with asking the doctor what kind of sterilization protocols will be followed. None of the sterilized instruments should be touched with a glove free hand, the orient must be properly draped and the operating area must be separate, organized and clean.

Infection at the site of implant placement can prevent healing from taking place and may even lead to an early implant failure. The patient may face problems like swelling, persistent pain, pus accumulation, and mobility of the implant. Mild infections can be expected to heal with a course of antibiotics, however serious infections require the removal of the implant.

In cases where additional bone grafting is also required, the need to avoid infection becomes even more critical.

Injury

Our jaw bones are chock full of nerves, arteries and veins running through them. They are also relatively sensitive to mechanical damage if improper forces are applied to them.

The two structures that are injured most often during implant placement include the inferior alveolar nerve in the lower jaw and the maxillary sinus in the upper jaw.

Both of these and indeed all injuries can be avoided with proper planning. In the case of the maxillary sinus, though, most cases will resolve on their own and only show up clinically as a persistent sinus infection. In rare cases, the implant itself can get dislodged into the maxillary sinus and may need to be removed through direct sinus surgery.

Injury to the nerve is much more serious and long lasting in effect. A slight injury to the nerve may result in a temporary loss of sensation to the areas which the nerve devices, however, more serious damage to the nerve can also result in permanent loss of sensation and paralysis of one side of the jaw.

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Thankfully, in complex cases, dentists can now make use of advanced radiographic techniques like CBCT which allow for a 3D pre-operative view and pinpoint precision planning.

The surgical skill of the dentist also comes into play in these situations. As a patient, it is better to be under the care of doctors who have been trained specifically in implantology.

More Risks With Dental Implants

Uncontrolled Bleeding

Technically this can occur through injury to one of the major blood vessels due to poor planning or poor surgical technique, however, that is extremely rare.Most often, the patient would not have disclosed a history of antiplatelet drugs or blood thinners as they are commonly called leading to increased blood flow.

Bleeding disorders in which the blood takes an inordinately long time to clot or does not clot at all can also be undiagnosed in patients prior to surgery.

These complications can be quite serious and in the worst case scenario, maybe even life threatening. In most situations, though, an increased amount of bleeding can be managed through local measures taken during the surgery itself.

Most surgeons will have access to collagen sponges or collagen plugs that aid in the formation of a blood clot and stop bleeding. Simple things like applying pressure for a prolonged period of time at the site of bleeding is also quite effective.

None of these measures will be sufficient though if a major artery has been injured. These situations require a clear mind and the ability to either suture the artery (an extremely tough proposition at the best of times) or use electrocautery to stop the bleeding.

Clinics which are not well equipped can have a tough time dealing with these situations.

Damage To Neighboring Teeth

The natural teeth need to have a buffer of about 2 millimeters from the implant surface so that the blood supply to their ligaments does not get compromised. This is actually quite a basic rule and one that dentists should be able to adhere to without any trouble with proper planning.

Sometimes though during the surgery, practitioners can quite easily forget the simplest of things and end up causing damage to a perfectly good tooth.Interestingly, the space between two implants is usually recommended as three millimeters to ensure both have enough blood supply for healthy healing.

Implant Failure

Getting implant treatment done can be quite expensive and so the loss of these implants can hurt even more than the loss of the natural teeth! It is important to know however that in a small majority of cases, implants will not integrate with the body as they are supposed to even though there is no apparent reason.

As the numbers suggest, such a situation would happen extremely rarely. Investigators are in fact divided over whether these situations are genuine cases where the implants are rejected by the body or whether there are undetected errors causing the same.

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Conclusion

As you can see, most of the risks associated with implant placement can be minimized if proper precautions are taken. The importance of getting all the laboratory investigations done before a procedure is performed, taking a detailed and exhaustive medical history and planning the implant placement meticulously can never be overstated.

It is possible to turn complex cases simple through proper methods and to make simple cases complex through complacency.

As a patient, it is imperative that you share all relevant medical history with the doctor before any invasive procedure is planned.