Q and A: Fixing Loose Dental Implants

Fix loose dental implants

The sensation of a dental implant moving can signal that something needs to be checked.

If you experience the inability to chew, bite down, or have pain around your implant after having this type of oral procedure, see a dental implant specialist. Advanced dental implant technology assists Montgomery Dental Care in Woodbury, MN to offer you state-of-the-art treatment for all tooth implant issues that arise.

Dentists have better options than ever to replace missing or soon-to-be-missing teeth. Dental implants are often the treatment of choice as they have a long history of high success outcomes and pleased patients.

Studies Report a High 10-Year Success Rate of dental implants

Unlike dentures or a bridge as a standalone service, dental implants are permanent fixtures in your mouth and are designed to last your lifetime without becoming loose. While dental implants generally achieve a steady state of function, clinicians know that everything doesn’t always go perfectly, which is true with any medical device. But in this case, it is almost always

Dental implants are the sturdiest tooth replacement option on the market. But when things don’t go one hundred percent perfect, it is good to have answers, set expectations, and know what actions to take. This article provides the most comprehensive and up-to-date answers to questions commonly asked about this oral procedure.

How Common are Loosen Dental Implants?

Also called an “endosseous implant” or an “oral fixture”, these oral implants seldom loosen or fail. This oral surgery has very good odds in terms of dental and medical procedures. Additionally, only rarely does an implant itself break since it is protected inside the bone where it is located. Dental implants have a high success rate above 97% for 10 years, according to NHI on May 28, 2020. ^[1]. The Journal of Oral Medicine and Oral Surgery report on April 8, 2022, shows similar success rates and found a low overall failure rate of 3.11%. ^[2]

“This confirms the December 14, 2012, NIH study stating: “The present retrospective analysis resulted in a 10-year implant survival rate of 98.8% and a success rate of 97.0%.” Author Dr. Daniel A. Buser in the 10-year survival and success rates of 511 titanium implants with a sandblasted and acid-etched surface article also evaluated patient success presenting with healthy peri-implant soft tissues during the 10-year period.

Ensuring that the bone heals beautifully around the tooth implant

Marc L. Montgomery DDS can look at dental patient implants and assess their placement. We can select slices around that implant and get a good view from the top to the bottom of the implant to see well the bone is developing around the implant.

How Painful is Repeat Dental Implant Surgery?

Fixing a loose dental implant restoration is often less painful than the original procedure. In most cases, implant-supported restoration can be replaced without additional surgery. Often your dentist can simply fabricate a new crown, bridge, or denture and reattach it to the underlying abutment.

In general, dental implant surgery involves trauma to a patient’s gums and jaw. However, local anesthesia will numb your nerves and soft tissues surrounding the dental implant area. When numbed, you can expect no pain during the procedure. It’s common to feel pressure at times, but nothing that should cause you uneasiness.

What are the Symptoms of a Loose Dental Implant?

1. When it feels like the implant is moving.

2. When simple tasks like to bite down or chew become challenging.

3. Pain that generates from the site of the implant.

4. Abnormal gum recession.

5. Noticeable swelling of surrounding gum tissue.

6. Discoloration of the inflamed area.

7. When you can see bone loss.

Is my Tooth Implant Supposed to have Movement?

Even healthy teeth move a little bit from time to time. About 1/100th of an inch is considered okay for healthy teeth but is rarely detectable by the person. More movement than that and consistent movement of a dental implant may be considered a loose tooth. The movement is due to the periodontal ligament, which holds the tooth in place.

What does the Periodontal Ligament have to do with tooth implants?

The Periodontal Ligament (PDL) is a fibrous joint that anchors a tooth’s root to a person’s alveolar bone socket. It consists of fibrous connective tissue and holds the tooth in a sprung suspension which helps the tooth respond naturally to mechanical pressure during function. A dental implant does not have a PDL. So therefore it is more rigid than a natural tooth.

What Could go Wrong if a Dental Implant Becomes Loose?

If left unresolved the abutment may break or loosen more, especially after suffering trauma like a direct hit to the implant area. It is also possible that the implant crown may break or experience progressive loosening with direct trauma or neglect. You may end up with painful or swollen gums around the tooth, which may lead to other issues if left unattended. More often gum diseases create issues for existing implants. The best thing to do is to have it diagnosed as soon as possible.

Is it Possible to Tighten a Loose Tooth Implant?

Yes, it is possible. Some patients ask about making a loose dental abutment tighter; however, more often, implants loosen due to bruxism, or tooth grinding issues. A loose abutment is often fixed without compromising the integrity of the implant. In some dental patient cases, the oral dental specialist can remove the crown and tighten the connection.

What are the 1st Steps to Take if my Dental Implant is Loose?

If your dental implant seems loose, other issues may be going on in your mouth. It may or may not be related to an existing dental implant. The best thing is to call your dentist. An in-person dental visit is the best way to determine the underlying cause. For the immediate moment, avoid touching it or moving it with your tongue or in any way. Avoid harshly brushing it or chewing around the area until you have it checked out. Schedule an emergency consultation with an implant dental specialist.

Be bold and request being seen as soon as possible. The solution will depend on the problem and what caused it.

What Causes a Loose Dental Implant?

There are a few reasons why someone’s oral implant may be loose, and commonly, it has nothing to do with having a failed dental implant.

Here are the top causes of dental implant failure:

1. Abutment failure – The top of a person’s implant has a hollow area with an attachment (called an abutment) that gets screwed into. This abutment protrudes out of the gum and your crown is cemented to the top of it. Infrequently, but possibly, the abutment may begin to unthread from the implant, which caused it to loosen.

2. Failed osseointegration – This means that the titanium implant has not fully bonded with your jawbone. This is very rare, and usually only happens if something is holding back a normal healing process.

3. Gum Disease and Bone Loss – Gum disease or peri-implantitis can attack the implant just like they attack natural teeth. Unmonitored infection can set in during surgery, or more commonly, occur months or even years after placement. Poor oral hygiene is the common cause. If long-term or harsh, this preventable infection can eventually deteriorate the bone that is holding the implant in place. If this occurs, you may need a bone graft to enhance your jawbone density.

4. A Loose Crown – Implants are much the same as your natural teeth; they entail two core parts: the crown and the root. It can be said that the majority of loose implants are actually loose crowns. The crown is attached with dental cement, but sometimes the seal can is disrupted, causing the glue to lose its effectiveness. The simple solution is to apply more cement. If the crown completely falls out, it is replaceable. Crowns that crack and fracture due to teeth grinding or other injuries also require replacement.

5. Using aftermarket materials – In some instances when clinicians seek to cut costs, a dentist may opt to use aftermarket parts. This means that you may not gain the precise fit of parts made by the person creating the implant. All implants are custom and skillfully made at Montgomery Dental Care.

6. Missing the Proper Preload Target Torque – Dental implant torque tools that assist the person conducting the procedure need to be accurately used. Over- or under-reading the tools may occur if, after repeated use and sterilization, their markings have become difficult to read. If the ideal torque value is missed, the implant screw may loosen, causing micromotion or mobility of the abutment part. This in turn makes it easier for potential particulate titanium material to get into the gum tissue, which may fester into a foreign body reaction. It’s unlikely but possible that the implant screw or even the implant may fracture.

Is a Loose Dental Implant an Emergency?

A loose implant is of an urgent nature; it should be assessed immediately by your dentist. The problem will not go away on its own, so waiting for it to resolve itself is not an option. If left untreated, it is likely to only become a more serious problem.

Can a General Dentist do Implants?

General dentists can place the implant successfully if everything overall is healthy and no additional treatments are required. If the dental patient has sufficient jawbone strength and healthy gums and the tooth has not been missing for long, then a general dentist is up to the task most of the time.

A trained dental implant specialist is more likely to have advanced technology in the office and the experience to detect if additional issues exist.

How To Prevent Loose Implants from Occurring?

There are several actions you can take to lessen risks of a dental implant becoming loose over time.

• If you or your dentist suspects gum disease, seek treatment promptly.
• Don’t skimp on who you partner with. A skilled clinician will make the most accurate diagnosis, use the best techniques, and knows which material is chosen matters for long-haul success.
• Limit consuming hard and crunchy foods that have been identified to wear down crowns and exacerbate implant issues.
• Establish excellent, daily oral hygiene to prevent gum disease and infections that may weaken your implants. This includes 2-3-daily tooth brushings to remove plaque and tooth flossing to remove food, plaque and bacteria from near the implants.
• Follow through with regular dental check-ups and visit your hygienist for cleanings a minimum of twice a year. Implant patients who are poorly motivated to attend follow-up appointments have lower long-term success rates.
• Be diligent to follow your dental implant specialist’s aftercare instructions.
• If you need to blow your nose do so gently and avoid sneezing during the first few days after surgery.

How are Dental Crowns Attached to an Implant?

There are two approved and widely used dental treatments to secure your crown to your dental implant.

• The first is known as a cement-retained implant crown, This is when the crown is glued onto the abutment (remember that piece that links the implant to the final crown we discussed above).
• Secondly, we may opt for a screw-retained implant crown, in this use case, a carefully crafted hole in the crown let a tiny screw to be placed into the abutment. The abutment and crown become a unit that secures the implant in the bone.

Which is Better: Cement-retained Dental Implants or Screw-retained Implants?

Your dental implant specialist will determine what is best for each unique person. Everyone’s oral history and overall health have varying factors:

• Where the dental implant will be placed.
• The dental implant’s size and configuration.
• The difficulty level of placing the crown, dental implant type, and the dimensions of the crown needed.
• How challenging or easy removing an existing dental crown could be.

Many risks and advantages are considered when your dentist makes the choice with you. Investing in implant dentistry to replace missing teeth or resolve another cosmetic enhancement is your long-term oral health.

What Parts does a Dental Implant Consist of?

Regardless of the type used or the tooth being replaced, a dental implant consists of three basic parts.

First, the screw is placed into your jawbone; this is the actual dental implant. Once this has healed after your surgery the whole point is to place a new tooth on that dental implant.

Secondly, crafting a tooth so that it adheres to an implant involves what is known as an abutment. The abutment is screwed (or cemented) directly into the implant.

Third, Now on top of your abutment sits your final crown or denture. This final crown or denture restores the look and function of the tooth or teeth to normal.

What is a Tooth Implant Abutment Screw?

The dental abutment screw is the accepted device used to secure the abutment to your implant. It is a threaded fastener that is typically tightened until the final seating position is obtained. Since the implant post will substitute as the tooth root, it’s implanted deep into the bone.

Dental implant abutment screws come in many shapes and sizes. Additionally, many different screw types exist and there are also so many different oral instrument adapters to tighten and loosen dental implant components. Just like in carpentry, choosing the right screw and how it is placed depends on the expertise of the specialist placing the screw.

Commonly, 3.5mm diameter implants are selected for mandibular anterior teeth. If appropriate, their use should be avoided for maxillary anterior and the patient’s posterior teeth. The 5.0 x 6.0mm implant is regarded as capable of supporting any tooth in the dental arch.

What are Implant-Supported Dentures?

Implant-supported dentures are where two full arches of false teeth replace the natural upper and lower teeth. It typically is done after several teeth are removed. The arch is securely anchored to four-six implants, each in the person’s upper and lower jaw. This option is also known by the trademarked “All-on-4”.

What is the Cost of a Dental Implant?

Dental implant costs are reasonable – especially when compared to the escalating dental costs of delayed care. They are an ideal treatment choice with a high success rate for a wide range of individuals. When used as a solution for a missing tooth or multiple teeth, dental implants effectively replace the natural tooth or teeth that you had. They should be properly maintained to avoid potential issues. Routine dental care is the best defense for people with dental implants.

Every person’s oral needs are unique. Remember, this is a gold standard tooth replacement. In general, however, single dental implants cost starting at $2,500 to $4,500 per implant. this is not a cost estimate per procedure, but rather per implant. For a more accurate dental implant cost estimate, your dentist can tell you after your dental evaluation is completed.

At Montgomery Dental Care, we have 3D imaging capacity in-house, meaning it is included in your cost estimate. Should you have to pay for that 3D imaging separately, you may be billed between $200 and $400 for this additional service. Here is a more detailed answer to help you anticipate the cost of dental implants.

What Determines the Final Cost of a New Tooth or Teeth?

Each person may have extended factors, but common implant costs include:

• A comprehensive dental analysis, including a CBCT scan (3D radiographic imaging).
• When needed, the extraction of problem teeth.
• When needed, the added cost of a sinus lift or bone graft to make the jawbone healthy enough to keep the implant stable.
• The dental implant(s) installation.
• Abutment hardware placement.
• Accurate measurement and creation of the dental crown.
• The crown(s) placement.
• How much follow-up is needed.

How often is a Loose Dental Implant Avoided?

Dental implant survival and success rates at 1, 3, and 5 years post-loading are very high.

• The Journal of Oral Implantology estimates that the overall success rate of implant dentistry is around 98 percent. March/April 2022 ^[3]
• The survival rate for immediate dental implant (DI) placement is high at 8 to 10 years (97%), along with a high PES. February 28, 2022 ^[4]
• A positive outcome of implant restorations is reported in the December 4, 2018 Implant success and survival rates in daily dental practice: 5-year results of a non-interventional study using CAMLOG SCREW-LINE implants with or without platform-switching abutments NIH article. According to Sven Marcus Beschnidt, et. al, in the present study, “these dental implants in combination with platform-matching abutments have been shown to have high long-term success rates ranging from 97.8 to 100% at 5-year to 10-year follow-up”.

Life table analysis of cumulative implant success rate according to Albrektsson and Buser

Interval (months)	Implants in interval	According to Albrektsson et al.			According to Buser et al.
		Implants withdrawn during interval	Failures during interval	Cumulative success rate (%)	Implants withdrawn during interval	Failures during interval	Cumulative success rate (%)
Loading – 12	271	27	0	100	27	0	100
12–24	244	6	0	100	6	0	100
24–36	238	17	1	99.6	17	1	99.6
36–48	220	11	3	98.2	13	1	99.1
48–60	206	50	2	97.1	50	2	98.0
60–72	154	94	0	97.1	94	0	98.0
72–84	60	48	0	97.1	48	0	98.0
> 84	12	12	0	97.1	12	0	98.0

At our Montgomery Dental Care dental office, we do full mouth restorations as well, and have a 100% implant success rate. This specific type of treatment is one of our most popular smile makeovers.

What Criteria Determines a Successful Implant Restoration?

A successful implant restoration is namely the absence of pain, infection, neuropathies or paresthesia, peri-implant infection with suppuration, mobility, no evaluated bone level changes, and continuous radiolucency around the implant.

In patient surveys, people rated their satisfaction based on their ability to chew, to taste, their comfort, appearance, the fit of the tooth restoration without wiggling, and general satisfaction.

View Dr. Montgomery’s Implant Gallery and see the beautiful results firsthand.

Montgomery Dental Care Can Help

Dr. Marc L. Montgomery has a vast knowledge of implant survival, the performance of the prosthetic components, crestal bone preservation, pocket probing depth, and oral implant best practices, as well as teaches cosmetic dentistry to peers. If you have questions about dental implants or concerns about an upcoming procedure, get in touch with his helpful dental team at Montgomery Dental Care. When needed, give yourself superior dental implant solutions that your oral health and smile deserve.

Contact your Woodbury, MN dental implant specialist today at 651-738-1880

Resources

[1] www.ncbi.nlm.nih.gov/books/NBK470448/ by Ranjan Gupta, et. al

[2] www.jomos.org/articles/mbcb/full_html/2022/02/mbcb210065/mbcb210065.html by Editors-in-Chief: Jean-Christophe Fricain and Philippe Lesclous

[3] www.quintpub.com/journals/omi/abstract.php?article_id=22224 by Emad Estafanous, BDS, MSD

[4] www.practiceupdate.com/content/comparing-the-outcomes-of-immediate-vs-delayed-dental-implant-placement/131564/37/23/1 by Emad Estafanous, BDS, MSD, et. al