Periodontics & oral medicine, explained.

Can dental implants fail, and what causes failure?

Yes — dental implants can fail, though pooled 10-year survival is about 94.6% in systematic reviews (Moraschini et al., 2015). Early failure (within the first year) is usually failed osseointegration. Late failure is most often caused by peri-implantitis, a gum-disease-equivalent around the implant linked to smoking, poor oral hygiene, untreated periodontitis, and inadequate maintenance.

How much do dental implants cost in Pretoria?

A single-tooth dental implant in Pretoria is costed in separate parts: the implant placement (indicatively around R11,000–R25,000), the final crown (around R10,000–R15,000, billed by your dentist or prosthodontist), and any pre-surgical work such as bone grafting. There is no statutory tariff and no single fixed price; an itemised written estimate is issued after the consultation.

How long do dental implants last?

A well-placed, well-maintained dental implant can last for decades. Pooled 10-year survival is about 94.6% in systematic reviews (Moraschini et al., 2015), meaning most implants are still in place at ten years. Longevity depends on maintenance, smoking, diabetes, oral hygiene, and peri-implantitis. The visible crown often wears out before the implant itself.

What is peri-implantitis, and can a failing implant be saved?

Peri-implantitis is inflammation of the tissue around a dental implant together with progressive loss of the supporting bone. A failing implant can sometimes be saved if peri-implantitis is caught early — through professional decontamination and, where needed, surgery. Implants with extensive bone loss or that have become mobile usually cannot be saved and are removed.

What's the difference between an implant placed by a periodontist versus a general dentist?

Implant placement is core surgical training for periodontists and oral-maxillofacial surgeons; for general dentists it is a postgraduate add-on that varies in depth from a short course to extensive supplementary training. For a straightforward single implant in a healed site with good bone, an experienced general dentist with implant training can produce excellent results. For complex cases — multiple implants, aesthetic-zone work, bone grafting, full-arch reconstructions — specialist placement is the published standard.

What is a dental implant, and how does it work?

A dental implant is a small titanium (or zirconia) screw placed surgically into the jawbone where a tooth is missing. Over three to six months, the bone fuses with the surface of the implant in a process called osseointegration. Once integrated, the implant can support a crown, a bridge, or anchor a denture — replacing a missing tooth in a way that biting and chewing feel close to natural.

What is All-on-4, and is it right for me?

All-on-4 restores a complete upper or lower jaw with a fixed bridge of replacement teeth supported by four implants — two placed axially at the front and two tilted at the back. It suits some patients who have lost most teeth in an arch and want a fixed replacement, but not all; some do better with five or six implants or an overdenture. A specialist assessment decides.

When should a dentist refer to a periodontist or oral medicine specialist?

Refer when periodontal findings exceed routine management — pockets of 5–6 mm or more, progressive attachment or bone loss, furcation involvement, mobility, peri-implantitis, or an unclear prognosis — and refer any oral mucosal lesion that has not healed in two to three weeks, or any white, red, or pigmented patch you cannot confidently explain.