Sad story of dental implant complications… This woman had 4 implants done already in her lower jaw. She already lost one when she came to see me. You can see that the gum tissue looks really irritated and there is visible infection of the implants… they look terrible!!
These implants are failing and there is significant bone loss. The failing dental implants are causing what little bone she has left to dissolve away. The body is trying to get rid of them at this point.
The reason these dental implants are failing is that the implants were placed incorrectly. This is a complication that can occur regardless of computer guiding or not. Rather than the implants being centered in the bone they were leaning towards the tongue and not even fully in the bone! In just a few short years the implants failed causing pain in her overdenture no longer could snap in. The overdenture itself was very poorly made and the aesthetics did not beautify her face and lip support.
So not only did she have surgical complications but she had implant teeth complications as well.
She expressed to me that she went to in office that had very low prices for this procedure and seemed too good to be true.
After evaluating her through 3-D CBCT, photographs and a clinical exam I determined that these implants needed to be removed and could not be rescued. Some implants in other cases, that are not as bad can be rescued. A common term used for implants that are beginning to fail is peri-implantitis.
The plan in her case is to remove the implants and do a vertical ridge augmentation bone graft. Both the removal and the bone graft will be done at the same time.
At the first surgical visit under IV sedation, I removed the implants and did a bone graft with a membrane. Because so much bone was missing and I needed to grow the bone up vertically, I could not allow this patient to wear a denture over the top of the surgical area for a few months.
Typically I do not allow the patient to go without teeth but in this case there was no option due to the initial complication. Placing the denture over the surgical site would have caused incision line opening and bone graft failure leaving her with almost no lower jaw!
After a few months of healing, I placed new implants in the proper position and eventually made a new set of dentures to accommodate some locator snap-on abutments. Ideally she would have been better off with a fixed bridge but she says she is okay with removable snap-on overdentures.
In the final photos you can see that the gums are now healthy and the implants are more centered in the bone. The panoramic x-ray shows the bone is now dense and white-appearing rather than black- appearing and unhealthy.
The new teeth have a level bite plane and proper lip support. I think they greatly enhance her smile than where she started.
Complications can and do occur… This was definitely one of them! In the end, this ended up costing her much more. I was thrilled to be able to help her.
Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow-American Academy of Implant Dentistry