Thursday, June 29, 2017
What if it hurts when I bite down on my implant restoration?
In my experience, this is a really ominous symptom. Implants are meant to be housed in bone and have no ligament attached to them. Bone has no nerve endings and can't sense pressure. when a bone "hurts" its usually from soft tissue adjacent that has nerve endings.
When an implant "hurts" when my patient bites down this usually means it is failing. If I have a patient with a implant sensitive to pressure, my first thought is to send him or her to see the surgeon who placed the implant. If that is not possible, I send them to a different, surgeon who I know well , to better assess whats going on. Usually it ends up that bone around the implant is no longer ( or never was) "integrated".
Sometimes a radiograph taken of the implant clearly shows bone dissolution adjacent to it. Usually implants that are painful to biting pressure end up needing to be removed and the bone regrafted before my surgeon can place another one.
Implants with inflammation that has caused bone loss around the top threads (peri implantitis) are most often comfortable to bite on, since they still are well integrated by bone around the bottom ( the base of the implant). Although peri implantitis is not a desirable symptom, often steps can be taken by the surgeon to clean up the inflamed area and hopefully slow down or halt the causes of the implant's bone loss. This is usually caused by bacteria and if the cause can be removed (excess cement or contamination of the implant surface) it is hoped that bone loss around the implant will be stopped or slowed down.

I have a "strong bite" and my dentist recommends against an implant. He wants to install a bridge instead, but I don't like the hassle of flossing over bridges.
ReplyDeleteIs a "strong bite" really a problem?
I am not sure what he means by a "strong bite". But if you have an "unfavorable occlusion it could be a problem for an implant or a three unit bridge. A second opinion couldn't hurt.
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