Early Crestal bone loss takes place around implants prior to occlusal loading. This means that bone loss occurs around the implant in the first year following the implant procedure. The loss may be caused by a variety of issues including the biological factors of the patients. These factors may include:
- The condition of surrounding teeth
- The quality and volume of the patient’s crestal bone
- The condition and quality of the patient’s soft tissue
- Biomechanical factors can also lead to early crestal bone loss. These factors can include:
- Aspects of the surgery such as irrigation time at the procedure site and suture techniques used
- The design, dimensions, and material of the implant
- Augmentation procedures
How well the patient follows post-surgery directions and the patient’s overall long-term care of their teeth, as well as the care of their implant following surgery also play a role in early crestal bone loss.
Early implant failure occurs when a dental implant is rejected or fails in some other way in the early stages of healing. Although failure rates are low with dental implants as a whole, there are some things that increase the risk of early implant failure. How successful a dental implant is depends largely on the patient’s overall oral health, the experience of the periodontist, where the implant is placed in the mouth, and the type of dental implant used. Early implant failure is usually due to poor osseointegration, which can indicate impaired bone healing. Risk factors for failure include but aren’t limited to smoking, infection, insufficient bone quantity, poor bone quality, and characteristics of the implant. Other risk factors may include patient age and sex, implant height and surface properties, the type of surgical procedure, and not using prophylactic antibiotics. Recognizing preventable risk factors and mitigating them can help dentists improve patient outcome.
The loading of a dental implant refers to the placement of the prosthetic onto the dental implant hardware after the implant has healed. However, early loading is becoming more popular as patients are demanding shorter treatment times. This means that the implant may be loaded before tissues have fully healed and before the implant has completely osseointegrated. There are three types of loading: conventional, early, and immediate. Conventional loading of a dental implant takes place between three and six months after the placement of the implant hardware. However, extended treatment times may be undesirable for some patients, especially when the implant is being done in the front of the mouth. Immediate loading occurs about 48 hours after the placement of the implant hardware, however, studies show that immediately loaded implants are less successful than their conventional counterparts. Early loading refers to loading that occurs at any time between 48 hours and 3-6 months.