Although the success rate of the insertion of implants is really high – well above 90% –certain problems may still occur. Even this modern tooth replacement solution can have defects sometimes. The Implant or the screw holding the superstructure may loosen, and the latter can even break. Although it occurs rarely, artificial roots can be broken as well. Whatever problem we have to face with our dentures, there is absolutely no need for panic. Thanks to modern dentistry, the implants and the tooth replacement built on it can be saved by dental implant repair in most cases.

This article offers an overview of the following topics:

• Breakage of the implant
• Defects of the superstructure
• Causes for a cracked or broken implant
• Suggestions to avoid problems

The implant inserted in the Jaw Bone is fixed tightly and permanently. This way it can hold the tooth replacement built on it and bear the external forces affecting it while chewing. In some cases it may still loosen, starts to move or even falls out. This rare phenomenon may be a result of the following:

• insufficient extent of ossification, the implant’s imperfect integration into the jaw bone
• inflammation of the soft and hard tissues surrounding the implant
• insufficient amount of bone material
• shifting effects resulting from early overload, loosening of connection to the bone
• inadequate primary stability during implantation into the jaw bone
• imprecise surgical intervention
• smoking

neglecting necessary oral hygiene (even more strict in this case), non-compliance of instructions

Whatever reason from the above is responsible for the loosening of the implant, if the artificial roots have once loosened, they cannot be “fixed”. An implant in motion has little or no connection to the jaw bone. This can only be solved by the insertion of a new implant. The moving, loose artificial root must be removed as soon as possible. If it is a possibility based on the condition of the bone, the gum and the oral cavity, a new implant has to be inserted to replace the loosened one. Before the insertion of a new implant, jaw bone restoration or even sinus lift may be necessary

Breakage of the implant

There is a very low possibility that the artificial root screwed into the jaw bone gets broken. (The superstructure and the screws holding it are more likely to get broken.) In case of today’s more developed implants this problem almost never occurs. Still, certain issues may arise during manufacturing, the insertion or the usage. Implants usually get cracked or broken due to the following reasons:

• manufacturing or material defect
• imperfect integration into teeth structure, malpositioned implant
• physical or biomechanical overload

Physical overload might be a result of external forces affecting the jaw bone and the oral cavity (e.g.: accident). Biomechanical overload can be, for example, continuous teeth grinding (bruxism).

Whatever the cause of its breakage may be, replacing the implant is the only solution. However, the insertion of new artificial roots is considered a new implantation. When calculating the time necessary for complete recovery, the ossification period taking three to six months must also be taken into account.

Defects of the superstructure

Defects of superstructures screwed into implants can be dealt with more easily. The problem can usually be solved locally, without having to worry about a longer healing time.

The screw holding the implant superstructure may loosen. In this case, the patient feels that the tooth replacement is unstable; it is moving. If no break or crack has occurred, the issue can be solved by tightening the fixation screw.

The problem is more serious, however, when the fixation screw of the superstructure is cracked or broken. Should this be the case, the screw must be removed and replaced with a new one, or must be repaired on the spot. If the fixation screw gets broken, the issue is very problematic because, in the first place, certain damaged parts may be stuck in the implant, and their removal becomes more difficult.

Causes for a cracked or broken implant

The screw holding the superstructure gets cracked or broken during a very few cases of implantations only. There may be various reasons for this to happen, including material defect, but the following problems are more frequent:

• The tooth replacement does not fit in the teeth perfectly. During chewing and biting the superstructure and the fixation screw are affected by extensive external forces.
• The surgeon that carries out the implantation does not adjust the axis of the artificial root perfectly.

Negligence and carelessness of the patient; instead of seeking medical care in case of a loosened implant, they wait until it is cracked or broken.

Suggestions to avoid problems

There are some basic rules that you should follow so that you can use your implants with great satisfaction:

• You should have the implantation carried out by a dental expert who has significant and verifiable experience in this field. It is important that this expert is assisted by a complex team.
• Follow the instructions of your doctor during the first phase of implantation carefully.

Avoid overloading the implant during the ossification period! Start using your implant gradually, according to your doctor’s instructions, even when osseointegration is complete.

It is vital that inflammation around the implant is prevented. Thus, the environment of the artificial root and the implants must be cleaned even more thoroughly than usual. Failure to do so may result in periimplantitis, which is a rapidly progressive inflammation around the artificial root. The implant may loosen or even fall out at the end of this process. Beside daily cleaning, professional dental cleaning of the dentures is necessary from time to time.

It is also important that you visit your dentist immediately if you experience even the slightest change with your implant. Unpleasant breath odor or taste, and latent pain or tension that is difficult to identify are all causes for concern, and should be examined. These symptoms all indicate that a negative process has been taking place in the environment of the implants.

If you take the initial symptoms seriously and seek medical help, you can prevent the occurrence of more serious problems.

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