What does 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" it usually means it is failing. If I have a patient with a sensitive implant 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 , in order to 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 implants 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.

from Ask Dr. Spindel - http://lspindelnycdds.blogspot.com/2017/06/what-does-it-mean-if-my-implant-hurts.html - http://lspindelnycdds.blogspot.com/

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