參考:
  1. Common Implant-Related Advanced Bone Grafting Complications: Classification, Etiology, and Management.Implant Dentistry.17(4):389-401, December 2008.
  2. Implant Surgery Complications: Etiology and Treatment. Implant Dentistry.   17(2):159-168, June 2008.
  3. Common Implant Esthetic Complications.Implant Dentistry.   16(4):340-348, December 2007.
  4. Implant Reversible Complications: Classification and Treatments.Implant Dentistry.   14(3):211-220, September 2005.
整理:

Irreversible complication
  1. Horizontal movement, vertical movement, bone lose down to 1/3 of total implant length.
  2. sensitivity, pain during function.
  3. complete apical radiolucency.
手術時發生的併發症:
  1. Overheat: 47度,1min會造成bone necrosis, high speed/up-down motion during osteotomy is suggested.
  2. Primary stability: longer/wider implant is suggested when there was lack of stability, When it's not possible, removed the implant and augment it.
  3. Malpositioned: Surgical stent/diagnostic wax-up/3-D anatomy should be evaluated before surgery. Position can be corrected by Lindermann drill, small gap between implant/bone (<1.25mm) is not critical for survival.
  4. Excessive angle: implant reposition and GBR should be done when buccal dehiscence. When violating the 2mm distance from adjacent teeth, Endo should be done for latent infection.
  5. Nerve injury: Can result in altered sensation(Paresthesia) or Anesthesia. Implant should be removed or put a shorter one in. clonazepam (Rivotril), carbamazepine (Tegretol), vitamin B-complex can be prescribed.
  6. Excessive hemorrhage: Often involved in 3 arteries. Inferior alveolar/Lingual/Facial arteries. Don't use gauze packing, coz no hard tissue in the mouth floor can be against with. Ask Pt to steak out tongue ,raise the mouth floor and apply pressure against mandible. Posterior superior alveolar and infraorbital arteries may be violated during open window, bone wax or electrocautery can be used for hemostasis.
  7. Sinus membrane perforation: Collagen membrane can be applied when the perforation >3mm, Primary closure and antibiotics, decongestant (e.g.,oxymetazoline 0.05%) should be provided.
  8. Mandible fracture: Be careful with severely resorbed mandible(height<7mm,width<6mm). Reduction/monocortical plate stabilization should be done for union healing. Implant can be kept if absence of infection. Soft diet only.
  9. Ingestion/Aspiration: should refer to hospitals, Chest x-ray to rule out ingestion/aspiration, Bronchoscopy if aspirated within 24hrs.
術後早期的併發症
  1. Incision line opening/implant head exposure: Should complete expose the implant with healing abutment to prvent further bone loss.
  2. Implant apical lesion: May caused by bacterial contamination, poor surgical tech., poor bone qulity, premature occlusal loading. If <1/2 length is affected, apicoectomy can be performed. If implant has lost stability or>1/2 length infected. Implant should be removed, and further augmentation or wider implant can be performed.
術後晚期的併發症
  1. Dislodgement into sinus: It may occur during abutment connection when implant length is <7mm in posterior maxilla. Implant should be retrived from lat.window or the original hole. Primary closure for preventing oroantral fistula. 
  2. Wrong angulation: Implant can be trephined out, wider inplant or augementation can be done.
  3. Implant mucositis: Polish/debride with rubber cup. CHX has no clinical benefit
  4. Peri-implantitis:For a shallow defect (vertical defect <2 mm) resulting from peri-implantitis,a nonsurgical approach of mechanical debridement combined with systemic antibiotics or implantoplasty with a high-speed finishing bur may be used. In the defects >2 mm, complete degranulation, antibiotic rinse of the infected site, and implant surface decontamination with sandblasting or tetracycline for a smooth surface and citric acid for a rough surface are recommended before the regenerative procedure. 
作假牙時的併發症:
  1. Abutment screw loosening: may occur when excessively occlusal load applied or the screw was untightened. Cause of the problem should be removed before tight the screw. Check abutment height(if >7mm), occlusal table(if too wide), implant angulation(if >15 degree) and remove cantilevers then do occlusal adjustment.
  2. fixture fracture: It may occur when bone loss reach the fracture line. implant can be removed or let it sleep.
  3. Ceramic fracture: poor inter-arch space may be the cause. New prosthesis should be made instead of fixing it with resin.
  4. Peri-implant infection: Radiographic f/u, pocket depth, mobility should be checked regularly. GBR can correct the defect, but let the prosthesis unloaded for 6mths
美觀的併發症:
  1. gingival recession: a burst of recession may occur during the first 3 months of abutment connection.1mm recessed is expected after prosthesis delivery
  2. Interproximal papilla loss: implant-implant distance should >3mm, Contact to crestal bone should< 5mm to prevent loss.
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