risks during surgery
Dental implants are a surgical procedure and carry the normal risks of surgery including infection, excessive bleeding, and bone necrosis or tissue damage around the implant. Nearby vessels or nerves, such as the inferior alveolar nerve, sinus and blood vessels, can also be injured when drilling into bone or placing an implant. Even when the lining of the maxillary sinuses is perforated by an implant, long-term sinusitis is rare. The inability to place the implant into the bone to provide stability for the implant (referred to as primary stability of the implant) increases the risk of failure to fuse with the bone.
Immediate risks after surgery
Infection (preoperative antibiotics reduce the risk of implant failure by 33% but do not affect the risk of infection).
excessive bleeding
Reflex soft tissue collapse (less than 5%)
Risks of the first six months
Initial implant stability
Initial implant stability refers to the stability of a dental implant immediately after implantation. The stability of a titanium screw implant (implant) in the bone after a patient’s surgery can be evaluated using a resonance frequency test. Sufficient initial stability may allow immediate loading with construction of the prosthesis, although early loading poses a higher risk of implant failure than late loading.[40]
Docking failure
The implant is tested between 8 and 24 weeks to determine if it is integrated. There is a wide variety of criteria used to determine implant success, and the most common criteria at the implant level are no pain, movement, infection, bleeding gums, inflammation visible on X-rays, or a loss of more than 1.5 mm of bone around the implant. The success of dental implants depends largely on the skill of the doctor, the type and amount of bone present in the area, and the oral hygiene of the patient, and the most important factor is the initial stability of the implant.[41] While there is a wide variation in the failure rate of implants to fuse (due to individual risk factors), approximate values range from 1 to 6%. [42]
Long term risks
Long-term complications are related to factors in the patient and others to technology. There are risks associated with the appearance, including the shape of the smile, poor quality of the gums such as retraction or loss, difficulty in matching the shape of the natural teeth and other times. Orthopedic or not brushing teeth, which results in poor oral hygiene, which affects the success of implants. [43]
Risks can be related to biomechanical factors, where the geometry of dental implants is different from natural teeth in terms of support, such as when there are extensions of the denture that are not centered on one side, or when the implants have fewer roots or teeth they replace (or when they are The crown-to-root surface ratio is low. Similarly, bruxism, bone deficiency or low diameter implants increase biomechanical risks. Finally, there are technological risks, as the implants themselves can fail due to fracture or loss of adherence to the teeth to be supported.[43]
