Q: Dr. Crapo: Last year, about eighteen months ago, I got two implants to hold in my lower denture. I first had them put in and about six months later I had a denture fitted to them. All seemed to be going well and I was enjoying chewing for the first time in many years. I mean my lower plate was staying in and not moving as I chewed. About six months in I noticed when I bit down on one side I’d get what felt like a toothache. After a couple of weeks like that, I saw my dentist. He took an x-ray and said “your body has rejected your implants”. When I asked why, he said he wasn’t sure. Long story short, I had to have them out and now I’m back to square one, only this time with less bone than I started with. Why did my body reject the implants? Is that it now? Am I a hopeless case who’s got to gum it through the rest of my life? I’m confused and depressed.
A: You’ve asked a simple question, the answer to which can be very complex. At the outset, if an implant is placed properly in a healthy individual, it is very rare that is doesn’t integrate. In other words, the body likes implants so it nearly always accepts them, and bone grows very tightly around it. When an implant is “rejected”, it usually happens soon after placement. The reason it happens is idiosyncratic, which means we can’t explain why. In my training many years ago, I saw this occur after a very experienced and conscientious surgeon placed implants, one on each side of the upper central incisors. One failed in the first two months and the other one integrated. The failing implant was removed, bone grafted and six months later a new implant was placed and succeeded. It is possible that diseased tissue lying dormant in the bone prevented its growth around the implant.
It’s hard to say why one or both of your implants failed. Here are some of the reasons others have failed. First, too much force on the implants through the denture. This means that the denture was worn continuously (24/7) and the person was a clencher. Second, when the implants were placed the gum surrounding them was poor quality and a gum graft should have preceded implant placement. Poor quality gum doesn’t resist mouth movement and this gum moves up and down on the shaft of the implant, allowing greater bacterial invasion. Third, poor hygiene – oral bacteria cause disease around implants just as they do around teeth.
Implants require maintenance, so work with your dentist once you have an implant restoration, be it a single crown or a denture. No, your case is not hopeless, it’s worth revisiting your condition. I am certain you can be helped with a comfortable secure restoration.