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implantology section

Complications in implant Dentistry

Angela Cowell and Beatriz Sanchez-inigo highlight the most common complications in
implant dentistry and how to prevent them where possible

Dental implant treatment can significantly CLASSifiCAtion of
improve a patient’s function, aesthetics CompLiCAtionS
and quality of life. However, this treatment Arguably, the most comprehensive
is not without complications. This article classification of complications is by the
aims to highlight the most common International Team for Implantology (ITI)
complications so they can be recognized by (Bragger and Heitz-Mayfield, 2015), which
all practitioners. divides these into:
Being aware of complications at an • Surgical
early stage means they can be intercepted • Biological
and managed as soon as possible – before • Aesthetic
implant failure. In addition, this article • Hardware
discusses how to prevent complications For the purposes of this article, the
where possible. As Eleanor Roosevelt said: common implant complications are divided
‘Learn from mistakes of others, you can’t into those occurring early and later in a
Fig 1: Implant placed too close to the inferior live long enough to make them all yourself.’ patient’s treatment.
dental canal; a suitable safety zone has not been Even before treatment starts, a patient
planned
must understand that complications can EARLy CompLiCAtionS
occur, despite clinical skills, experience Early complications can occur at the time
and irrespective of the apparent cost of of surgery or in the weeks after this, as well
treatment. Where different clinicians as during the restoration process. Here,
place and restore implants, a clear early complications are further divided into
handoff between the implant surgeon and ‘surgical’ and ‘restorative’ subsets.
restorative dentist is needed, as well as
excellent relationships between clinicians SuRgiCAL CompLiCAtionS
and laboratories. 1. Nerve damage and uncontrolled
When complications occur, good patient bleeding
communication is essential. Explaining the Nerve damage and uncontrolled bleeding
problem and its ramifications clearly and are the most significant complications of
what resolutions may occur is an important implant surgery. Thorough digital planning
responsibility for those undertaking with the use of cone beam computed
implant dentistry. Asking colleagues and tomography (CBCT) scans and planning
Fig 2: Incorrect angulation of implant UL4 discussing cases are learning opportunities. software should mitigate risk to the interior
Campbell and Hare (2022) explained the dental nerve, its branches or any vessels
importance of audit in the January issue of (Figure 1). Particular attention should be
Clinical Dentistry. It is extremely valuable to paid to the anterior lingual canals during
log your complications to enable reflection, anterior mandibular implant placement.
and perhaps identify patterns that lead to a If these vessels are breached and bleed,
change in your practice. Having this dataset this can lead to swelling in the floor of
also helps you accurately explain your the mouth and airway compromise. This
success rates to patients. would be a medical emergency requiring
urgent hospital treatment. It is important

‘Learn from mistakes of others, you can’t

Fig 3: Short sutures live long enough to make them all yourself.’
causing ulceration
of soft tissue Eleanor Roosevelt

38 Dental Practice i July-August 2023 i Vol 19 No 4