Implant complications
Differentiate technical failure, biological inflammation and patient-centred concerns. Compare baseline records and identify the correct referral or maintenance response.
Understand
Implant complications may be biological, mechanical or aesthetic. Baseline records distinguish progression from normal post-placement change.
Assess
Assess probing, bleeding, radiographic levels, occlusion, mobility, component integrity and the patient's concern. Separate loose restoration from loss of osseointegration.
Apply
Address reversible hygiene or prosthetic factors and refer progressive disease or complex failure. Document the implant system and components before attempting repair.
Key distinctions
Mechanical complications include screw loosening, fracture and wear; biological complications include mucositis and peri-implantitis. A loose crown can imitate a mobile implant, but the implications differ substantially. Establish the system and baseline before intervening. Progressive bone loss or persistent suppuration needs a wider diagnostic and treatment plan than repeated surface cleaning.
Think through a case
A patient reports an implant crown moving. Determine whether the screw, crown or fixture is mobile before treatment, and compare radiographic and probing baselines.
The distinction to remember
Do not attempt to tighten an unknown component without identifying the system and the source of movement.
Test your recall
Does bleeding around an implant always mean peri-implantitis?
Show answer
No; bone loss and other findings are needed to distinguish it from mucositis.