How long does a dental implant last?

One of the most frequent questions that all those who have to get a dental implant ask is: how long does a dental implant last?

Well, the answer is as simple as it is disarming: we don’t know.
The scientific literature and clinical practice on the basis of our past experience show us that they can even last a few decades.
However, not all dental implants seem to be so long-lived (to the contrary!) and therefore the most pertinent question would be:

What factors are important in the lifetime of a dental implant?

Without going into a complex scientific discussion, we can certainly make a consideration: the long-term success of an implant depends mainly on 3 elements.

Thinking about it, these factors are the same that influence the duration of most functional products of man… let’s see them together:

1) The Project

Think of an engine that works for thousands of hours, think about the Colosseum or the Parthenon created by Fidia: The DNA of their longevity consists primarily of a valid design. The author of a correct implant design is the doctor that we rely on. The duty of the doctor is first of all to study the many clinical case variables: quality and volume of the tissues, habits of the patient (such as grinding, smoking or poor hygiene), systemic health, aesthetic and functional demands, and obviously the compliance or involvement of the patient in following the hygienic guidelines, etc…

A pondered implant rehabilitation plan, with satisfactory perspectives of duration and predictable qualities comes from a correct evaluation of these variables.

Example of long-term implant success: implant inserted in 2003… today in perfect clinical and aesthetic conditions.

An ideal project, however, is not enough without a coherent implementation… To that effect, a precise surgical execution is very important. However, personally I am convinced that very many implant complications do not depend on the unskilful hands of the surgeon, but on errors of evaluation that could be avoided in the design phase, i.e. before the surgical phase.

A well-studied implant rehabilitation design is obviously implemented thanks to a good surgeon, but also with…

2) High quality materials

The implants are not just “little screws” in the bone, as we often hear… they are rather complex elements (and therefore expensive)

• the design of the screw (the dimensions, the coils, the pitch, the shape… conical or cylindrical…) is very important. Different designs correspond to different properties of the implant, suitable for different clinical cases. The quality of the implant design is the result of studies, research and clinical assessments that can last for decades.
• the external surface of biological interface; there are many types and qualities: an implant surface that has the necessary biological characteristics is a fundamental element in the integration between implant and bone.
• the implant-prosthetic connection systems; these are too many to count. These have the task of binding the implants to the fixed prosthesis (the teeth), to respect the gum tissues that surround them, and obviously to resist the countless chewing loads, without unscrewing or fracturing. A connection that is not sufficiently precise or well-designed promotes complications from bacterial infections or even a fracture of the implant. This last complication, whose treatment is often complex, jeopardizes irreversibly the duration of a rehabilitation.

The connections that bind the implants to their respective “teeth” are fundamental elements for long-term success.

• the standardization of the systems for manufacturing, sterilization and storage. Not all manufacturers have the same controls on production standards. The quality also consists in the certainty that the product conforms to expectations: always.

3) Maintenance, ordinary and extraordinary.

the term maintenance is obviously not the one used in implantology, but it communicates well to everyone the role of home and periodic professional cleaning. Engines, industrial machines and buildings all need maintenance: without monitoring, without ordinary and extraordinary maintenance, engines stop and buildings ruin. Everyone knows this. In the same way, it is essential that the patient takes care of his implants every day and that he periodically goes to the dental office to perform a periodic assessment (obviously also of the implants) and a professional cleaning. These hygienic routines are fundamental to avoid complications with the implants in the medium and long term.  On the one hand, it is obviously in the patient’s interest to remember the checks and periodic cleaning, and on the other hand, our office offers its patients a service of periodic reminders.

After these considerations, I want to point out that only one condition above all relieves us from the care of dental implants and their possible complications: not needing dental implants.

For this reason, anyone who asks me about the new horizons in dental implantology… I reply that it is always much more interesting to talk about teeth: how to treat them, maintain them and, why not, how to enhance them. Because today more than ever, implants work and last but… The best smile, wherever possible, is always ours!