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Patient Information

Every patient must consent legally to their proposed treatment. There are often multiple options that must bechoosen from to determine the right course of treatment. With each treatment plan there are potential complications which must be disclosed before proceeding. When implants are placed in the bone there is the possibility of infection, nerve injury, sinus exposure, injury to other teeth and bone, and/or anesthesia complications. While the majority of these complications are rare, some of them may be permanent.The individual situation will determine the relative risk of these untoward events. While dental implants are very predictable and have shown high success rates and long-term stability, failure and loss of implants are possible. Implants are no longer considered experimental and when the conditions are correct success can be greater than 95% predictable over a 20-30 year period. You should realize, however that any device that functions is subject to wear. Routine follow-up and self care are critical to long-term success. While dental decay and corrosion of the implant parts is highly unlikely, peri implant disease or gum disease is still something that needs to be monitored on a regular basis. The restorative dentist will likely suggest follow-up every 3-4 months for at least a year to insure maintainance of the surrounding soft tissues and bone withprevention of inflammation or infection.

Early implant failure can be due to a number of factors but most commonly is related to either infection or nonintegration. Infections may be related to failure of soft tissues to protect from the normal bacteria that occurs intraorally. Fortunately, these types of infections are very rare. Prolonged antibiotic use in the first 1-3 weeks after surgery will likely be recommended. Late implant failures may be related to illness and medications. Uncontrolled diabetes or some medications may affect implants just as they may affect other types of metal joint prostheses. Lack of homecare is the single most common reason for late implant failure. Regular dental appointments for hygiene and maintenance will help retain implants as long as possible. Biomechanical failure can occur with the implant parts. Most implants are a two-part system with the implant imbedded in the bone and a prosthetic attachment which is screwed into the implant. This attachment may fracture if the forces placed on it create stresses that it cannot support. Fortunately, in many situations the attachments are stock and can be replaced without having to replace the overlying crown or superstructure. Unfortunately, if the crown or superstructure is custom made to a custom abutment, the overlying prosthesis may need to be remade even though the implant is still functional. Finally, bad habits such as tooth grinding and smoking will adversely affect the long-term success of implants.The surgeon will advise quitting smoking at least during the surgical procedures and the integration phase of the implant. Because research has shown that smoking is probably the single most important factor in the development of gum disease, seriously consider quitting smoking if implants are to beplaced.


 

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