What causes dental implants to become loose?
Dental implants can become loose for a variety of reasons. Some of the most common causes include:
- Infection – Bacterial infections around the implant can cause inflammation and bone loss, leading to loosening.
- Improper osseointegration – Osseointegration is the process by which the bone grows around and fuses to the implant. If this fails to happen properly, the implant may not be firmly fixed in the bone.
- Periodontal disease – Chronic gum infections can cause bone loss around the implant and loosening.
- Bruxism – Clenching and grinding of the teeth puts excess force on implants and can gradually loosen them.
- Trauma – A blow or injury to the face can disrupt the implant’s integration with the bone, resulting in loosening.
- Mechanical issues – Problems with the abutment, crown, or implant itself can sometimes cause loosening.
Catching and addressing implant loosening early is important to prevent further complications and the need for implant removal. Patients should have regular dental examinations to monitor the health of their implants. Any sensations of movement, pain, or changes in occlusion around implant restorations should be promptly reported to the dentist.
What are the risks if a dental implant becomes loose?
A loose dental implant is at high risk for complications and failure if left untreated. Some of the potential risks include:
- Loss of the implant – As an implant loosens, its foundational support in the jawbone deteriorates. This can eventually lead to complete loss of integration and the implant falling out.
- Damage to supporting teeth – A loose implant can put damaging lateral forces on adjacent teeth, causing fractures or loosening of otherwise healthy teeth.
- Bone loss – Micromovement of a loose implant can accelerate bone loss around the implant. This can make treatment more difficult and compromise the jawbone.
- Infection – Bacteria can infiltration around a loose implant, spreading infection through the bone (osteomyelitis).
- Abscess – Infection may culminate in a pus-filled abscess in the bone around the implant, requiring surgical drainage.
- Sinus issues – A loose upper molar implant may impinge on the maxillary sinus, causing sinusitis.
- Swallowing risk – A very loose implant may detach and get aspirated or swallowed.
- Aesthetic concerns – Implant loosening can make teeth look unattractively spaced or misaligned.
Prompt consultation with a dentist allows early intervention to stop loosening from becoming worse. If caught in time, many implants can be successfully retreated.
Can a loose dental implant be saved?
In many cases, a loose dental implant can be retained with proper intervention. The prognosis depends on factors like:
- Degree of loosening – Slightly mobile implants have a better prognosis than severely loose implants.
- Bone loss – More bone loss reduces the chance of salvaging the implant.
- Health of surrounding bone and tissues – Poor bone quality makes retreatment more difficult.
- Infection – Active infection may require implant removal.
- Patient health – Medical issues like diabetes complicate implant reintegration.
- Characteristics of the implant itself – Well-designed, high-quality implants have better survival.
If bone loss around a loose implant is minimal, retreatment may include:
- Scaling and debridement to remove infection
- Disinfecting the implant surface
- Prescription antimicrobial rinses
- A period of reduced loading with a soft diet to allow bone to regenerate
- Occlusal adjustment to ensure even biting forces
- Bone grafts to stimulate bone growth around the implant
- Use of growth factors to promote osseointegration
With moderate bone loss, the implant may be salvaged by:
- Surgical exposure of the implant
- Removal of any failing bone
- Bone grafting around the implant
- Guided bone regeneration with membranes
- Suturing soft tissue back around the implant
If these efforts fail and the implant continues to loosen or bone loss is severe, the implant will need to be removed and potentially replaced with a new one after sufficient healing.
How can a loose dental implant be tightened?
If an implant is diagnosed with only mild mobility, dentists may be able to mechanically tighten it. This involves:
- Unscrewing the abutment – The abutment is the connecting piece between the implant and crown. The dentist uses a small tool to detach it from the implant.
- Accessing the implant – Any overlying soft tissues are moved aside to visualize the loose implant body.
- Irrigating the internal threads – Saline solution is used to flush out the threaded hole inside the implant.
- Applying antibacterial agent – An antimicrobial solution like chlorhexidine may be used to disinfect the implant’s internal chamber.
- Using a torque wrench – A calibrated torque wrench with a compatible driver tip engages the implant’s internal hex and tightens it clockwise.
- Reattaching the abutment – Once sufficiently tightened, the abutment is replaced and screwed back into the implant.
- Verifying tightness – Bone sounding and percussion are used to confirm lack of mobility.
- Suturing gingival tissues – The gum tissues are closed back over the abutment.
This torqueing down of the implant is analogous to tightening a screw. It provides an immediate mechanical stabilization, but still requires follow-up bone regeneration procedures to reestablish osseointegration.
How much does it cost to tighten a loose dental implant?
The cost to tighten a loose dental implant is typically between $500 and $1,500 depending on the extent of care needed beyond simple tightening:
| Procedure | Cost |
|---|---|
| Implant tightening visit | $500 – $800 |
| X-rays | $100 – $200 |
| Bone grafting | $500 – $1,200 |
| Membrane/growth factor use | $300 – $500 |
| Follow up visits | $200 – $400 |
More extensive reconstruction to salvage a very loose implant with considerable bone loss can cost from $2,000 to $4,000. Regular dental insurance policies do not always cover implant complication treatments, but dental savings plans may offset some of the expense.
When is a loose dental implant beyond repair?
There comes a point when an implant with advanced loosening and deterioration cannot be saved. Signs that an implant is beyond salvage include:
- Severe bone loss over half the implant length
- Mobility greater than 1 mm in any direction
- Inability to tighten the implant due to damaged internal threads
- Presence of peri-implant radiolucency indicating osteolysis
- Unresolved chronic infection and inflammation
- Pain, swelling, or abscess formation
- Damage to adjacent teeth or sinus cavity
- The implant body is fractured
- The implant has lost integration on all sides (360° of mobility)
At this point, the only options are to remove the failing implant and either replace it with a new one after healing (if adequate bone remains), or change the treatment plan to a non-implant prosthesis like a bridge or partial denture.
What happens when a loose dental implant is not treated?
Leaving a loose dental implant untreated is a poor decision that allows complications to get progressively worse. Potential consequences of neglecting a loose implant include:
- Total loss of the implant into the surrounding tissues
- Infection spreading through facial spaces
- Abscess formation within the jawbone
- Progressive bone loss at the site
- Damage to adjacent tooth roots
- Fracture of the implant, requiring surgical removal
- Proliferation of bacteria to other oral sites
- Eventual need for more complex and expensive interventions
- Generalized dental shifting, eating problems, and aesthetic concerns
In severe cases, hospitalization on IV antibiotics may be needed to control rampant infection. Thus, it is critical not to ignore signs of implant mobility and to see a dentist promptly for assessment and repair before the implant fails completely.
Can you get an infection from a loose dental implant?
Yes, a loose dental implant is at high risk of becoming infected. This occurs because:
- Micromovement impedes reintegration of the implant with the bone.
- Gaps form between the implant and bone, allowing microbes to enter.
- Bacteria flourish around the mobile implant, forming biofilm.
- Inflammation and progressive bone loss ensue.
- The contaminated implant surface harbors infection.
Common oral microbes like streptococci and Porphyromonas can spread infection into surrounding tissues and compromise the bone. Abscesses within the jawbone may also arise. In rare cases, infection can spread systemically through the bloodstream. Prompt antibiotic treatment and tightening or removal of the implant is required to clear infection.
How long do tightened dental implants last?
When a loose dental implant is detected early and tightened before extensive damage occurs, the prognosis for long-term retention is good. With proper follow-up care like bone grafting and good oral hygiene, a tightened implant may continue functioning for many years.
Factors that improve long-term prognosis after tightening include:
- Only mild bone loss before treatment
- Swift intervention within weeks of noticingloosening
- Patient commitment to follow-up care and maintenance
- High-quality implant materials and design
- No underlying health conditions impairing healing
- Avoidance of smoking and tobacco use
- Regular dental cleanings and checkups
Under optimal conditions, a tightened dental implant has over a 90% chance of surviving more than 10 years. With regular maintenance and monitoring, implants may even remain functional for 20 years or more after being initially stabilized. However, signs of recurrent loosening warrant prompt reevaluation.
Can I replace a loose dental implant myself?
Attempting to replace a loose or failing dental implant oneself is strongly discouraged. Proper implant removal and replacement requires surgical expertise, specialized equipment, and ideal clinical conditions to avoid complications.
Self-performed implant dentistry risks:
- Incomplete removal leaving fragments embedded
- Nerve injury or excessive bleeding
- Sinus perforation
- Damage to adjacent teeth
- Jaw fracture
- Invalid placement angle of the new implant
- Introducing infection
- Premature implant failure
- Aesthetic or functional problems with the restoration
Only a trained oral surgeon or restorative dentist has the knowledge to properly extract failing implants, graft bone as needed, select optimal new implant components, and flawlessly place the replacement implant for best results.
Can I remove a loose dental implant at home?
You should never attempt to remove a loose or failing dental implant on your own at home. Doing so risks severe complications including:
- Airway obstruction if the implant or a fragment is aspirated or swallowed.
- Bleeding, pain, and swelling from traumatic removal.
- Jaw fracture if excessive force is applied.
- Nerve damage causing numbness or paralysis.
- Dislodging the implant into facial spaces requiring hospital retrieval.
- Introduction of infection into facial planes.
- Sinus perforation if performed on upper implants.
- Leaving broken remnants requiring surgical intervention.
Only oral surgeons have the necessary skills, anesthesia options, and equipment to remove implants and all associated components gently and completely. Appropriate follow-up procedures are done to promote optimal healing and prepare for eventual reimplantation if desired. Let a professional handle implant extraction to avoid disastrous outcomes.
Conclusion
A loose dental implant is a serious issue requiring prompt attention to halt progression and retain the implant if possible. Mildly mobile implants detected early can often be mechanically tightened and stabilized with follow-up bone regeneration. More severely loose implants may need surgical intervention to attemp salvage. However, severely damaged or infected implants with extensive bone loss will require removal and replacement once healed. Leaving a loose implant alone leads to worsening bone loss, infection, and eventual failure, so see a dentist right away if you notice signs of implant mobility. Trying to remove or replace implants yourself can cause severe harm, so always have implant procedures done by an experienced oral surgeon. With prompt professional treatment, many loose implants can be retained and remain functional for years after being tightened.