Our Summary

This research paper discusses the issues around dental implants, which are often used unnecessarily due to a mistaken belief that they are better than natural teeth, even when those teeth are diseased or failing. This has led to a global increase in complications related to dental implants, especially those related to aesthetics and biology. Sometimes these issues can’t be resolved to the patient’s satisfaction, and the implant has to be removed.

The paper discusses how this removal is now done in a minimally invasive way, using a technique called reverse torque engineering, which helps preserve the tissues around the implant. It also talks about how replacing failed implants has become more feasible, with a high success rate.

However, the paper warns that dentists should carefully consider whether replacing an implant is the best course of action for the patient, taking into account their specific needs and desires. If a future implant is considered, the approach should be based on the specific characteristics of the patient’s oral tissues.

The paper acknowledges that there is still a lot we don’t know about the biological changes that occur after an implant is removed, which makes these decisions difficult. The current recommendations are mostly based on guesses rather than solid evidence.

In conclusion, this paper reviews the reasons for replacing implants due to complications, how to make these decisions, how to plan and carry out the replacement, and what outcomes can be expected.

FAQs

  1. What are some of the complications that may arise from inappropriate and unnecessary implant therapy?
  2. What methods are currently used for the removal of dental implants to preserve peri-implant soft and hard tissues?
  3. What considerations should be made in decision-making, planning, and implementation of implant replacement?

Doctor’s Tip

A helpful tip a doctor might tell a patient about dental implant surgery is to follow all post-operative care instructions carefully to ensure proper healing and successful integration of the implant. This may include avoiding certain foods, practicing good oral hygiene, and attending follow-up appointments with the dentist. It is also important to report any unusual pain, swelling, or discomfort to the dentist immediately to prevent potential complications.

Suitable For

Patients who are typically recommended for dental implant surgery include:

  1. Patients with missing teeth who are looking for a permanent solution for tooth replacement.
  2. Patients with failing or diseased teeth that are not salvageable with other dental treatments.
  3. Patients who are looking to improve their oral function and restore their ability to chew and speak properly.
  4. Patients who are seeking a more esthetically pleasing smile and want to improve their overall appearance.
  5. Patients with sufficient bone volume and quality to support the dental implants.
  6. Patients who are in good general health and do not have any medical conditions that would contraindicate dental implant surgery.
  7. Patients who are committed to maintaining good oral hygiene and attending regular dental check-ups to prevent complications such as peri-implantitis.

It is important for patients to consult with their dentist or oral surgeon to determine if they are suitable candidates for dental implant surgery and to discuss the potential risks and benefits of the procedure.

Timeline

Before dental implant surgery:

  1. Patient consults with a dentist or oral surgeon to discuss the need for dental implants.
  2. Comprehensive oral examination and imaging are conducted to assess the patient’s oral health and bone structure.
  3. Treatment plan is formulated, including the number of implants needed, type of implant, and timeline for surgery.
  4. Patient may undergo pre-operative procedures, such as bone grafting or tooth extraction, to prepare the implant site.

After dental implant surgery:

  1. Patient experiences some discomfort and swelling immediately after surgery, which can be managed with pain medication and ice packs.
  2. Healing process begins, during which the implant fuses with the jawbone in a process called osseointegration.
  3. Patient returns to the dentist for follow-up appointments to monitor healing and ensure proper integration of the implant.
  4. Once the implant has fully healed and integrated, a custom-made dental crown or bridge is attached to the implant to restore function and esthetics.
  5. Patient is advised on proper oral hygiene practices to maintain the health of the implant and surrounding tissues.
  6. Regular check-ups with the dentist are recommended to monitor the implant’s long-term success and address any potential complications.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with dental implant surgery?
  2. How long will the recovery process take and what can I expect during the healing period?
  3. What type of anesthesia will be used during the procedure and what are the potential side effects?
  4. How many dental implants do I need and where will they be placed in my mouth?
  5. What materials will be used for the dental implants and are there any alternative options available?
  6. How long do dental implants typically last and what maintenance or follow-up care will be required?
  7. What is the success rate of dental implant surgery and what factors can affect the outcome?
  8. Will I experience any pain or discomfort during or after the procedure, and what pain management options are available?
  9. How much will the dental implant surgery cost and will my insurance cover any of the expenses?
  10. Are there any lifestyle changes or dietary restrictions I should follow before or after the dental implant surgery?

Reference

Authors: Monje A, Nart J. Journal: Periodontol 2000. 2022 Feb;88(1):182-200. doi: 10.1111/prd.12418. PMID: 35103326