What are some common dental implant problems?

Dental implant problems vary from surgical to prosthetic issues and from easy to very difficult. Below is a list of various issues we have seen over the years.

Loose dental implant abutment screw

This one is a fairly easy fix unless in the front of the mouth and access to the screw is not straight forward. The hard part is figuring out why the screw is loose. Most often it is a lateral excessive contact. The screw should be replaced with a new screw if this occurs. This occurs somewhere around 0-6% Pjetursson 2014

Fractured dental implant abutment screw

Much more complicated issue. Can sometimes be removed with a piezo. If cold welded then that is a problem. Here are the steps and options to fix a dental implant screw fracture.

dental implant problems — Abutment screw fracture

Fracture of dental implant abutment

Implant abutments can fracture. This is more common with the ceramic zirconia abutments or hybrid implant abutments. Certain design types are prone to this such as 3i with their abutment fingers. If there is a loose screw for awhile the fingers can easily break. However, even the normal titanium abutments will fracture occasionally.

$Implant titanium abutment fracture.$ Ti base separating from the crown

This is an issue with more of the screw retained implant restorations as most are done with a small titanium chimney and a zirconia crown luted to it. We have an entire page on ti bases.

Dental implant abutments can fracture if they are metal are debond if they are luted titanium chimneys.

Tissue level implant breaking at the head.

Similar to the abutment breaking, a tissue implant can break at the same spot. We often consider these less prone to fracture but it can happen as seen in this DT thread.

$A tissue level dental implant fracture can occur.$

Fracture or chipping of dental implant crown

This is the one of the three most common technical complications found by Pjetursson 2022 Perio. Fairly common and we treated the same as we treat a crown fracture on a regular tooth. This is more common on dental implants due to lack of proprioceptive feedback. Pjetursson 2014 found this in 3-35% @ 5 years.

Implants can break and “flowering” is the most common type of implant breakage.

We have a page on flowered dental implants and on broken implants and how to remove them. When we see a broken implant it is usually a mini implant or a break in an implant system with a very thin metal rim on the top.

Broken mini dental implants — 4 broken dental implants

Dental implant that is broken or flowered — You could probably say this is a flowered dental implant.

Implant abutment breakage or implant breakage?

Some cases both are broken and you are not sure which came first. Abutments can certainly break and implants can can flower, when both occur, no way to know which came first. This case has a broken MUA and a broken implant. The root cause was an all on 4 with too much cantilever.

The implant may be showing and cause biological or esthetic issues.

We have a page on implants that are showing and how to treat.

Cement sepsis of dental implants

Major issue because it can cause loss of implant and is very common. Again, this is a problem that many of “solved” through better techniques. Not using resin cement and using custom abutments along with a duplicate of the abutment to aid in cementing should solve this problem.

Open contacts between dental implant crowns and natural teeth

This is one of the most common issues we see with dental implants. An open interproximal contact on an implant crown happens to a lot of people. There are many solutions and we cover this more extensively in our blog on the topic.

Post implant placement patient growth

Placing a dental implant in an individual that is too young will definitely cause a problem as the dental implant will stay in the same place as the bone and teeth move around. You can see some of the esthetic issues in our too young for dental implant page. However, even in adults this is an issue. Secondary growth, growth and facial changes after the age of 17-18, is common. While growth does continue for life it seems to slow as we age.

One solution to fix this is orthodontic reposition of a dental implant. The only way to move a dental implant is to move all the bone that is healed to the implant. We can accomplish via a block corticotomy, well not us but some super-specialists. Not an easy thing to accomplish. This case on dentaltown shows a great result.

Craniofacial growth article discusses this phenomenon and other growth issues. A follow up interview with several other doctors discussing the issue further.

Where does bone growth occur?

This is one of those things that is easier to show than tell.

While there is certainly other dental implant problems, especially surgical dental implant problems, these are the most common.

There are also implants placed in a poor position. Finally there is the dental implant failure.