Absolute Contraindications

Implants can not be placed in the following situations:

  • Heart diseases affecting the valves (valvulopathy),

  • Recent infarcts,

  • Severe cardiac insufficiency, cardiomyopathy,

  • Active cancer, certain bone diseases (osteomalacia, Paget’s disease, brittle bones syndrome, etc.),

  • Certain immunological diseases, immunosuppressant treatments, clinical AIDS, awaiting an organ transplant,

  • Certain mental diseases,

  • Strongly irradiated jaw bones (radiotherapy treatment),

  • Treatments of osteoporosis or some cancers by bisphosphonates (as tablets: ACTONEL®, FOSAMAX®, DIDRONEL®, LYTOS®, SKELID® etc. and PARTICULARLY as INJECTIONS: ZOMETA®, AREDIA® etc.), even several years before.

Relative Contraindications

The indication to place implants will be evaluated on a case-by-case basis, with the greatest caution.

  • Diabetes (particularly insulin-dependent),

  • Angina pectoris (angina),

  • Seropositivity (absolute contraindication for clinical AIDS),

  • Significant consumption of tobacco (read pdf)

  • Certain mental diseases,

  • Radiotherapy to the neck or face (depending on the zone, quantity of radiation, localization of the cancerous lesion etc.),

  • Certain auto-immunes diseases,

  • Drug and alcohol dependency,

  • Pregnancy.

Relative Local Contraindications

The indication to place implants will be evaluated on a case-by-case basis, with caution.

  • An insufficient quantity of bone,

  • Certain diseases of the mucous membranes of the mouth,

  • Periodontal diseases (loosening of the teeth); it is necessary to clean up the gums and stabilize the disease first,

  • Severe grinding or clenching of the teeth,

  • An unbalanced relationship between the upper and lower teeth,

  • Infections in the neighboring teeth (pockets, cysts, granulomas), major sinusitis,

  • Poor hygiene of the mouth and teeth.

*this is a general presentation of all contraindications, an accurate specialist examination is needed before any implant procedure.

Immediate Complications

Risk from the anaesthetic

Even though it is performed under local anaesthesia in the vast majority of cases, the risk from an anaesthetic is never zero. An allergy, although extremely rare, is always possible. However, this type of anaesthesia is very widely used and the "at risk" subjects are often already known.

Non-osteo-integration of the implant

(Also called "rejection" but wrongly) It becomes apparent in the weeks or months that follow insertion of the implant.

The material used is pure titanium, whose physical and biological properties are very well known and which has been used for many years in orthopaedic surgery (hip and knee prostheses, etc.). It is very well tolerated by the body and no rejection or allergic reactions have been reported so far.

The bone cells have not colonized the surface of the implant and it is mobile as it is not "soldered" to the bone. So the implant will have to be removed. For that reason we generally wait 2 to 6 months before finally making the prosthesis on the implant.

The causes are not always identified, however, tobacco and hygiene play a non negligible role.

Overall this involves 5% of implants placed. A 100% success rate does not exist for implant treatments.

However, if it is possible, an implant can be re-inserted in the same site some weeks or months later, and quite often, this second attempt is successful.

Infections

Post-operative infections are rare. An abscess sometimes occurs in the neighborhood, or (much more rarely) an infection of the soft tissues around the jaw bone (the infection is called cellulitis) or a sinus infection (sinusitis).

For this reason you are prescribed antibiotic therapy, since the conditions of asepsis must be as near as possible to absolute and we should avoid operating when the body is weakened (by another infection, poorly controlled diabetes etc).

Haemorrhages

As with any buccal surgery, a haemorrhage or a haematoma may occur, but this is not serious in the vast majority of cases.

Lesions of the nerves

In the lower jaw (mandible) lies the nerve serving the lip and the chin which runs inside the bone (in the region of the premolars and the molars). For this reason a scan is also requested in order to locate it accurately, and sometimes, if the depth of bone is insufficient, you will be refused an implant in this area.

Very rarely the nerve can be touched, while the implant is being performed (due to a technical error, a poor understanding of the scan, the patient moving at the moment of drilling, etc.), or afterwards by a compressive haematoma or oedema.

This results in a reduction in the sensitivity of the lip and chin (not paralysis). These disorders are generally reversible upon appropriate treatment.

Exceptionally, there can also be a lesion of the lingual nerve which gives anaesthesia of the tip of the tongue.

Late Complications

Late failure – several years after placement – can be due to mechanical factors (pathologic masticatory forces), loosening of the implant (as a natural tooth may), lack of hygiene or a generally weak condition.

This results in the loss of the implant (which no longer holds) or more rarely its fracture.

Hence the importance of very rigorous hygiene and regular checkups for preventing if necessary any irreversible pathology.