Implant complications: risk evaluation, diagnosis, management and outcomes

Dental implants and their restorations have become an accepted and predictable modality of treatment. The literature reflects excellent long-term survival rates. However, survival of an implant does not necessarily translate to success, and in between these two outcomes lies the world of implant complications. Complications associated with dental implants occur with both the restorative and surgical components, with the restorative component complications being more frequent and to some extent, more easily managed. Surgical complications are difficult to manage, and can be the result of many aspects of the implant surgery. Potential complications can arise from poor planning, poor case selection, and poor execution. Complications can also occur where no technical or surgical errors are apparent, but where biology and the fundamental flaw of the trans-mucosal design of dental implant prostheses, adversely affects the outcome. This presentation outlines the nature of potential complications and looks at practical and pragmatic methods, first to try to prevent complications, through improved case selection and execution; secondly, it discusses the most effective methods to prevent complications in implants already installed, by adequate maintenance programmes. Lastly, it deals with those cases which require clinical management of the complications. This presentation provides the clinician with a greater understanding of the difficulties in managing implants that are not progressing as we, the clinicians, and the patients, had originally expected.