Dental implants are a lot like teeth. Like teeth they have the ability to stay in place for a lifetime if properly cared for. But, also like teeth, they are vulnerable to gum disease. However, unlike teeth, we have the ability to engineer dental implants with attributes that can potentially preserve them against infection.
There are several techniques people are using to try to achieve this goal of an infection-resistant dental implant.
One of the easiest approaches to keeping oral bacteria off dental implants is to use an antibacterial coating. The most basic coating is a variation on chlorhexidine. Chlorhexidine is a common mouthrinse that is very effective at controlling gum disease.
More exotic coatings have also been proposed. One that has already passed some basic tests is a silica sol-gel coating. Since silica has already been shown to help the implant integrate with the bone, this coating has a double benefit.
Adding coatings to dental implants would kill oral bacteria, but the antibacterial solution would leach out of the implant. The goal is to combat early failure of the implant (failure during the first year which accounts for about 60% of all implant failures or 2-4% of all implants). Once the implant is integrated, it is more resistant to infection.
A more novel approach is to actually build dental implants with a built-in reservoir for antibiotics. This new idea has the benefit that it would allow the constant application and reapplication of antibiotics. The effect could be prolonged indefinitely, allowing treatment for the full life of the implant.
It also has the benefit that the antibiotic doesn’t have to be used unless necessary. The reservoir can be left without antibiotic until the need arose. Then antibiotic could be added to the implant to combat an infection. This could help protect against the development of resistant bacterial strains.
Perhaps the most outrageous approach to making an implant antibiotic is to design an implant material that is fully of microscopic bacteria traps. As bacteria slither across your implant, they stumble into these traps where tiny knives stab and kill them.
Now, don’t worry, these knives are so small that they can’t hurt anything larger than a cell. And their placement is such that they won’t harm your body’s cells or interfere with integration of the implant. But they can kill bacteria. And they can keep killing bacteria, theoretically throughout the life of the implant.
Proper Maintenance Protects Implants
None of these antibacterial approaches are really available today. So for now, dental implants depend primarily on good oral hygiene to protect them from infection.
Fortunately, maintaining dental implants is just the same as maintaining natural teeth: brush, floss, and make your regular checkups.
But as these do become available, we will evaluate the technologies and select the ones that will best help our patients to get successful dental implants.