Expert Witness Journal Issue 65 February 2026 - Flipbook - Page 59
Implant Failure and How It
A昀昀ects the Cost of a Claim
by Dr. Raj Kumar, Dental Surgeon
Introduction
Dental implants have been used for over 60 years
to replace missing teeth, either as single units or as
part of dental bridges. The most common material is
titanium alloy, which has been scienti昀椀cally studied
since implants were 昀椀rst introduced into clinical
practice.
When preparing reports on causation and prognosis,
I am frequently asked the following questions:
•
How long is this implant likely to last?
•
Can the claimant reasonably claim the cost of
future replacement implant crowns?
•
If so, how many replacements should be allowed
for over a lifetime?
It is well recognised that a natural tooth can last a
patient’s lifetime if they have a clear medical history,
good oral hygiene, and good dietary control.
Conversely, patients who do not look after their
teeth may su昀昀er premature tooth loss due to decay
or periodontal disease.
standards of placement and aftercare are higher
than in general practice. This may not re昀氀ect
everyday clinical reality.
These individual factors must be taken into account
when preparing cost reports for claimants. It is the
responsibility of the dental expert to review the
claimant’s dental history prior to the accident and
assess whether the lost tooth would reasonably have
been expected to last for the claimant’s natural
lifetime.
Ideally, a robust scienti昀椀c study assessing implant
longevity would include a large number of patients,
a large number of implants placed by multiple
operators, and long-term follow-up of at least 10–15
years. Unfortunately, most available studies fall
short of this ideal, meaning that we cannot state
with certainty how long all implants will last, even
when well maintained.
Although implants have been used for many
decades, there are relatively few long-term studies
with su昀케ciently large patient numbers to provide
consistent evidence regarding true implant
longevity. Most published studies last between 5
and 15 years and typically involve smaller patient
cohorts, which limits the strength of the conclusions
that can be drawn.
Review of a Major Long-Term Study
One of the largest published studies reports over 22
years of follow-up and includes nearly 11,000 dental
implants:
“
Many scienti昀椀c studies are retrospective and are
often carried out by the clinician who placed the
implants, usually within specialist practices where
EXPERT WITNESS JOURNAL
Long-term clinical performance of 10,871 dental
implants with up to 22 years of follow-up: A cohort
study in 4,247 patients”
- D. French et al.
57
FEBRUARY 2026
