I had a great patient come in today disappointed because one of his two implant fixtures failed during the healing phase prior to uncovering. I have come to think of dental implants as invincible, the one procedure that never fails. Unfortunately, despite very low failure rates, we do have patients that encounter a problem. As I explained today knowing that the failure rate is less than X percent means nothing when you are in that group. In that case your experience of failure is 100 percent. I did what I know to do, and listened, acknowledged the frustration and disappointment without dismissing it or explaining it away.
So what is the real failure rate for single tooth dental implants? A retrospective study including patients from 1982 until 2003 was published in 2005 in the International Journal of Oral and Maxillofacial Surgery. They found overall a failure rate of 8.16% in the maxilla and 4.93% in the mandible. The American Association of Oral and Maxillofacial Surgeons quotes a 5% failure rate on it’s website. Most of the studies I reviewed had failure rates of between 7-10%, granting a certain level of reliability in these numbers. There are patients who have risk factors which will correlate to much higher failure rates. Smoking current or past is a risk factor for implant failure along with diabetes, age at time of treatment over 60, head and neck radiation therapy and post-menopausal women who are on hormone replacement therapy.
I was surprised that patients who have quit smoking are still at high risk, and the total years they smoked is a more direct indicator if risk then whether they are current or past smokers. One of the things that has always been true in our profession is that no one treatment is right for everyone, so yes there are still situations where fixed bridges or even removable solutions may be in the patient’s best interest.