By Prim. Dr. Tome Tasevski

Several years ago a new patient came into my practice scheduled for an examination and consultation, and what was the reason? Well, my dear readers, he had a broken implant. When I saw the x-ray I just said: this cannot be real, it is titanium, is it possible titanium to break?! But, by the years, several patients came into my office with the same problem, so my next question was: Do I extract it or just leave it? Before answering this question, firstly, I would like to explain my observation and conclusion why do implants break.

My main interest in these cases was that the body of the dental implant was broken. Usually, we see a breakage at the screw that connects the abutment (crown carrier) with the implant and this is not a big problem because there are tools and techniques to extract the broken screw and replace it with a new one. But, when you see the implant body breakage, then you have to do a very precise surgery in order to take it out from the bone and replace it with a new implant.

There are several key reasons why dental implants would break:

  1. Bad quality control by the manufacturer;
  2. Titanium used by the manufacturer is of suspicious quality;
  3. Geometry and design failures;
  4. Dentist did not follow the instructions given by the manufacturer, which concerns certain model and design of implant;
  5. Diameter used by the dentist is inappropriate with the bite pressure according to the alveolar region (frontal or molar teeth);

If you observe the pictures shown here you will see that usually the breakage is at the upper third of the body of the implant, i.e. where the body is thinner, i.e. where the screw is screwed. What does this tell us? That the implant placed does not have the capacity to endure the bite force. And, what does this mean? That the implant placed does not match either the alveolar bone zone placed or axis of the implant is too sharp or bent versus the bite pressure.

Now, we can speculate here, adding the first 3 points to the problem, but I think that 4 and 5 are more regular. Why do I state this? Simply, because dentists rarely make good plans and analytics before carrying out the implantation or generally dentists use 1 surgical set (one brand) and 1-2 models of dental implants (same brand) not knowing or not understanding that every dental implant geometry, design and philosophy is different. It is not the same to put a dental implant for carrying denture, crown and bridges, or to place the dental implants at the front of the alvolar bone or at the molar region, even on upper or lower jaw. You can learn more about this visiting our link where you can visit each brand separately and educate yourself.

Now, lets return to my initial question: Do I extract it or just leave it?

Well, using the piezo technology, I have extracted more of the broken implants and implanted new. Some of them were left but I implanted new next to them because the extraction would cause more damage to the bone and I preferred to avoid the bone augmentation. No need for that because there is no problem living the osseointegrated implant. It will be a part of your body for your whole life and will not cause any health problems.

I could not finalize my observation completely and make comparisons of the broken implants because nobody of my patients had the implant passport. I was not able to compare or study the model of the broken implant, brand etc. which is very important for this text. So, if you are a future patient please read carefully

You can never know what the future brings!