Dental implants are considered to be the gold standard of tooth replacement options for a number of reasons. One of these reasons is because of their high success rates. On average, around 95-96% of dental implant procedures are successful. As impressive as this is, there is still a small percentage of implant procedures that unfortunately fail. Because of this, there are numerous studies being conducted that center around identifying reasons for implant failure, as well as ways to overcome these potential risks.
When dental implants are placed in the jawbone, the surrounding bone will grow around the implant, fusing it in place and allowing it to act as an artificial tooth root. However, when the implant is unable to fuse properly with the jawbone, then it is said to have failed. Currently, it is known that the following factors can affect dental implants:
- Smoking: patients who smoke or who have smoked in the past are at an increased risk of implant failure since the chemicals found in cigarettes have been found to impair healing.
- Bone Mass: dental implants are unable to fuse with the surrounding bone if there is not enough bone mass to allow the bone to grow around the implant. In some cases, this can be remedied using a bone graft.
- Oral hygiene: patients who adhere to good oral hygiene habits are more likely to experience implant success, while those who have poor oral hygiene habits are more likely to face implant failure.
- Gum Health: past periodontal disease increases the risk of postoperative infection that can impede implant success.
- Diet: Eating hard, crunchy, or chewy foods too soon after implant treatment can cause the implant to shift and heal improperly or fail to heal altogether.
In addition to these known factors, a recent study published in the European Journal of Dentistry has noted another possible factor that can affect implant success: chewing habits. While implants are known for their ability to restore chewing function, the way an individual chews has also been found to be important to implant success. Specifically, researchers set up a study to determine if a change in the dominant chewing side could affect implant success.
The dentists associated with the study noted that, “Most people don’t chew symmetrically on both sides of the jaw but have a dominant side that accounts for up to 75% of chewing movements”. Chewing predominantly on one side of the mouth exerts additional force on the teeth found on that side, as well as the jaw joint on the opposing side. While most dental implant dentists take this into account when placing implants, researchers wanted to know what would happen if the dominant side suddenly changed.
To find out, they conducted a study of 64 individuals who were having implants placed on one side of the mouth. These 64 individuals were between the ages of 22-67, free from periodontal disease, had minor defects in the lower jaw, and had satisfactory oral hygiene habits. Before having implants placed, dental x-rays of the teeth and CT images of the jaw were obtained. Patients also had their chewing strength tested. Then, the dental implants were placed.
After dental implant surgery, patients were examined at the 3-6 month mark and the 9-12 month mark. During these exams, the dental x-rays and CT images were repeated to monitor the progression of the implant. Additionally, patients had their chewing strength tested again and were also asked about their chewing habits. Researchers found that 62% (40 out of 64) had a change in their dominant chewing side, while 38% (24 out of 64) had no change.
The patients were then divided into two groups based on whether or not they changed their dominant chewing side. Those who had changed were placed in subgroup A, while those who did not change were placed in subgroup B. While most of the patients from both subgroups experienced implant success, there were slight differences in each of the subgroups.
For example, only 5% of individuals in subgroup B experienced bone resorption associated with implant failure, as compared to 10% of subgroup A. Individuals in subgroup A were also more likely to experience bone resorption earlier at the 3-6 month mark, rather than the one individual in subgroup B that experienced bone resorption at the 9-12 month mark. With this information, researchers concluded that changes in the dominant chewing side could increase the risk of implant failure.
Dr. Sadati possesses extensive experience in all aspects of advanced restorative dentistry, with an emphasis in cosmetic and implant dentistry. He has attained Accredited Fellow status in the American Academy of Cosmetic Dentistry (AACD), the most rigorous, demanding credentialing process in the world. He is the only AACD Accredited Fellow in South Florida.
