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What are the risks? — dental implants and prosthetics

Despite mature implant designs, medical and surgical procedures always carry risks.

Medical and surgical procedures carry risks. Despite mature implant designs, long experience and newer, less invasive placement methods and computer-assisted surgical techniques, complications can occur in implantology just as in any other medical therapy. Before the procedure your dentist will explain the possible risks of the treatment in detail.

Only a few examples of the risks are listed here:

  • Intraoperative complications
  • General intolerance reactions to the anaesthetic
  • Injury to important anatomical structures
  • Damage to nerves, particularly the mandibular nerve in the lower jaw. (Implant diagnostics and intraoperative imaging of the nerve make sure that the nerve is not injured.)
  • Postoperative complications: injury to blood vessels can lead to bruising, swelling and secondary bleeding.

Serious underlying conditions and the use of certain medicines can raise the risk of implant loss considerably. How great the risk of failure is depends on the severity of the illness and the dosage of the medicine.

Some of the factors that raise the risk are listed here:

  • Blood clotting disorders
  • Severe cardiovascular disease
  • Conditions that require treatment with cortisone
  • Reduced immune defences due to cortisone treatment
  • Radiotherapy or chemotherapy, and marked wound-healing disorders
  • Metabolic conditions such as poorly controlled diabetes mellitus, and autoimmune diseases
  • Certain drug intolerances, and certain bone conditions that require intravenous bisphosphonate preparations
  • Medicines such as bisphosphonates that interfere with bone metabolism

Late complications

Late complications with implants are rare. They are often traceable to chronic infection or inadequate oral hygiene. Implant mucositis and peri-implantitis (inflammation and recession of the mucosa and bone around one or more implants) are biological complications with an infectious cause. Peri-implantitis attacks the bone adjoining the implant, leading to infection-related peri-implant bone loss. If peri-implantitis goes untreated, implants are lost.

Answered briefly

Frequently asked questions

Damage to nerves is one of the possible complications, above all in the lower jaw, where the mandibular nerve (Nervus mandibularis) runs. Implant diagnostics before the procedure and locating the nerve during the operation are meant to prevent exactly that. The treating doctor explains the possible risks in detail beforehand.
Peri-implantitis is an inflammation with recession of the mucosa and the bone around one or more implants. It is one of the late complications, which are rare and usually go back to chronic infections or inadequate oral hygiene. If it is left untreated it attacks the adjoining bone and implants are lost.
Those named are medicines that disturb bone metabolism, in particular bisphosphonate preparations given intravenously, as well as cortisone treatments, which lower the immune defence. Radiotherapy or chemotherapy also increase the risk of losing an implant. How high the risk is depends on the severity of the illness and on the dosage.