What is a Dental Implant?
A dental implant is an artificial tooth root replacement that is surgically placed into the jawbone to support restorations like crowns, bridges, or dentures. Dental implants are made from titanium and other materials that are compatible with human bone. The implant fuses to the bone in a process called osseointegration, which provides stability and support for artificial teeth.
Do Dental Implants Ever Shift Position?
Yes, in rare cases, dental implants can shift position after being placed. However, with proper placement and care, implant shifting is uncommon. Here are some key factors related to potential implant shifting:
- Bone density: Low bone density can increase chances of implant shifting. Dense bone provides sturdy support.
- Placement angle: Angled implant placement adds pressure and may cause gradual shifting over time.
- Loading too soon: Immediate loading before full integration can cause micromovement and shifting.
- Parafunctional habits: Clenching, grinding teeth or chewing on hard items may cause excessive force.
- Improper fit: Ill-fitting restorations allow micromovement of implants.
- Trauma: A significant blow to the face can disrupt integrated implants.
- Location: Bottom implants are more stable. Upper implants have higher risk of shifting.
With optimal bone quality and proper placement, implants take 3-6 months to fully integrate into the jawbone. Following your dentist’s recommendations for progressive loading helps prevent shifting during the osseointegration period.
How Much Can Dental Implants Shift?
Most implant shifting is minuscule, ranging from 0.2mm to 1mm. This minor change may be undetectable to the naked eye. More significant shifts of 1-3mm can cause greater issues:
- Discomfort or pain from implant micromovement
- Misaligned, loose implant crowns or bridges
- Damage to surrounding bone and other teeth
- Infection due to bacteria entering gaps between implant and bone
Greater shifts above 3mm indicate implant failure. The implant will require removal and replacement surgery.
What Causes Dental Implants to Shift?
The main causes of dental implant shifting include:
Insufficient Osseointegration
Full integration of the implant into the jawbone is necessary for long-term stability. When integration is interrupted or rushed, the implant may not adhere properly. Smoking, bone disorders like osteoporosis, poor bone density, and radiation therapy can hinder osseointegration.
Immediate Loading
Placing too much pressure on an implant too soon increases shifting risk. Restorations should not be placed until the implant has integrated over 3-6 months. Immediate restoration loading right after implant placement should only be done under strict protocols.
Poor Positioning
Incorrect angle, depth, or alignment during implant placement can lead to failure. Improper drive direction when inserting the implant can also contribute to shifting forces. 3D imaging, computer-guided surgery, and experienced clinicians help avoid poor positioning.
Excessive Biting Forces
Habits like teeth grinding and crunching on hard foods can traumatize the implant and surrounding bone. People with these tendencies require milled implant restorations to prevent excessive force. Nightguards are also recommended.
Reaction to Foreign Material
In rare cases, the body identifies the titanium implant as a foreign object and activates the immune system. This causes inflammation and bone loss around the implant, leading to shifting.
Can a Shifted Dental Implant Be Repaired or Saved?
If detected early, minor implant shifting under 1mm can often be corrected. The dentist may use small stabilizing screws or bone grafts around the implant to reinforce it. Impression materials and bite registration are used to ensure restorations fit perfectly.
Significant shifts above 1mm often require implant removal. The dentist will then graft bone at the site before placing a new dental implant after several months of healing. In cases of extreme bone loss or trauma, sinus lifts, ridge expansion, or bone block grafting may be necessary to rebuild the implant site.
Poor positioning may also necessitate redoing the entire procedure. After removal, the dentist can attempt to place a new implant in a better orientation.
How Can Shifting Dental Implants Be Prevented?
Follow these best practices to avoid dental implant shifting:
- Allow enough healing time. Wait 3-6 months for full osseointegration before loading implants.
- Quit smoking. Smoking impairs healing and bone integration.
- Attend regular dental visits. Your dentist can assess the implants and surrounding bone.
- Improve oral hygiene. Poor hygiene can cause bacterial inflammation and bone loss.
- Avoid chewing hard foods. Stick to a soft diet to prevent excessive force.
- Wear a nightguard. Protect implants from nighttime teeth grinding.
- Get occlusal analysis. This measures your bite force to avoid overload.
Poor implant positioning is usually out of your control. Choose an experienced and reputable dentist or oral surgeon to place your implants accurately the first time.
What Are the Signs That a Dental Implant Is Shifting?
Look for these signs that may indicate a shifting dental implant:
- Pain or discomfort around the implant area
- Swelling, inflammation, or pus discharge around the implant
- Loose crown, bridge, or denture no longer fitting properly
- Changes in bite feeling off or uneven
- Visible gaps between the implant and surrounding bone
- Halitosis or bad taste from implant site infection
- Difficulty or pain when chewing
- Sudden cold sensitivity in the implant tooth
- A visible change in alignment of the implant tooth
Any noticeable physical or functional changes related to your dental implant warrant a prompt visit to your dentist. Early intervention gives the best chance of correcting implant shifting before necessitating removal. Monitor your implants closely and follow up with regular dental exams.
When to See a Dentist About a Shifted Implant
You should see a dentist right away if you experience any symptoms of implant shifting like pain, loosening, discomfort, or changes in tooth alignment. The dentist will take x-rays to look for visible movement along the implant-bone border.
Even if no symptoms are noticeable, be sure to see your dentist every 6 months for checkups. Professional implant monitoring is crucial for early detection of subtle implant shifting before complications escalate. Have any ill-fitting implant restorations evaluated promptly as well.
See a dentist immediately if trauma like a sports injury or car accident impacts your face. The force could dislodge integrated implants. Dentists can splint damaged implants to prevent further shifting.
While a minor 0.2mm shift may just require close monitoring, significant shifts above 1mm usually need intervention. Surgery to remove and replace a failed shifted implant has the best outcome when treated quickly.
Can a General Dentist Correct a Shifted Implant?
General dentists have basic training to place and restore dental implants. However, complex shifted implant cases usually require an oral surgeon or specialist like a periodontist or prosthodontist. Here’s why specialist intervention may be advisable:
- Advanced diagnostics: Specialists have access to advanced 3D CT scan technology to evaluate the extent of implant shifting and bone loss.
- Surgical experience: Specialists perform more complicated implant revision procedures on a regular basis.
- Bone grafting skills: Periodontal specialists excel at regenerating lost bone to stabilize implants.
- Restorative expertise: Prosthodontists can fabricate customized restorations to get shifted implants functioning properly again.
General dentists have the basic skills to monitor and maintain stable, healthy implants over time. But they often refer shifted cases to oral surgeons and specialists for complex surgical corrections and rehabilitation.
What Is the Success Rate of Replacing a Shifted Implant?
The success rate of replacing a shifted implant is high – around 95% over a 5-year period when done properly. However, the new implant must be placed after sufficient bone has regenerated at the site.
According to research in the International Journal of Oral and Maxillofacial Implants, the 1-year survival rate is:
- 93.5% for immediately placed implants after extraction
- 97.1% for delayed implant placement after 12 weeks of healing
Delayed placement combined with bone augmentation has the best results. Factors that improve success include:
- Waiting at least 6 months for complete bone regeneration
- Skill and experience of the surgeon
- Adequate attached gingiva around the new implant
- Avoiding smoking during the healing period
- Careful treatment planning and implant site preparation
With precise technique and allowing enough healing time, replacement of shifted implants has a very favorable prognosis. Be sure to follow all post-op care instructions to enable proper osseointegration.
Can a Dental Implant Shift Years After Placement?
Yes, it is possible for a dental implant to shift many years after initial placement, but this is rare with proper long-term care.
After successful osseointegration, implants can last for decades. However, shifts and failures can still happen years down the road if:
- Peri-implant disease develops, causing bone loss
- The occlusal bite changes significantly over time
- Trauma or injury occurs years after placement
- Undetected initial issues like poor positioning worsen gradually
- Habits like bruxism place excessive force on the implant
With regular dental exams, x-rays, and bite analysis, long-term problems can be caught early. Well-integrated implants that are healthy at the 5-year mark have lasting potential. But ongoing maintenance and monitoring is a must.
Options if a Dental Implant Fails from Shifting
If an implant shifts and eventually fails, there are a few replacement options:
New Implant
After bone grafting at the site, the best solution is placing a new dental implant. With proper technique and allowing several months of healing, a replacement implant has a very high long-term success rate.
Fixed Bridge
An alternative is a fixed bridge anchored to healthy nearby teeth, with a false tooth filling the gap from the lost implant. This also requires grinding down adjacent teeth for bridge crowns.
Removable Appliance
Partial or full dentures are another option to replace a shifted implant. However, these are less comfortable and stable than fixed implant replacements.
No Replacement
If neighboring teeth are healthy, leaving the gap from a failed implant may be possible. But this can impair chewing function and allow teeth to drift into the space over time. Filling the gap is ideal.
Weigh the pros and cons of each option with your dentist. Dental implants still provide the best long-term results for replacing missing teeth.
Key Takeaways
- While rarely an issue with proper placement, dental implants can shift position due to factors like poor bone density, excessive biting forces, or trauma.
- Slight shifts under 1mm may be repairable through bone grafts and stabilizing screws. Larger shifts often require implant removal and replacement surgery.
- Specialist intervention from an oral surgeon or prosthodontist provides the best chance of salvaging a shifted implant.
- Prevention through healing time, regular dental visits, occlusal analysis, and avoiding excessive bite forces is key.
- Even years later, implants can shift due to progressive bone loss, changes in bite, injury, or unresolved issues.
- Replacing a shifted implant has a very high long-term success rate with adequate bone regeneration before re-implantation.
