Implant Removal

Dental Implant Removal

Although dental implants are designed to provide a long-lasting solution for missing teeth, there are situations where an implant may need to be removed. Implant removal is typically considered only when an implant has failed, become infected, fractured or is no longer functioning properly. At our office, implant removal is performed carefully using techniques designed to preserve as much surrounding bone as possible, allowing for future treatment options whenever feasible.

What Is Peri-Implantitis?

Peri-implantitis is an inflammatory disease that affects the gums and bone surrounding a dental implant. It is typically caused by harmful bacteria that accumulate around the implant, leading to infection and gradual destruction of the supporting bone. If left untreated, peri-implantitis can cause the implant to become loose and may ultimately result in implant failure.

Peri-implantitis is similar to advanced periodontal (gum) disease around natural teeth, but it occurs around dental implants. Early detection and treatment are important because the condition is often easier to manage before significant bone loss has occurred.

Signs an Implant May Be Failing

Although implants have a very high long-term success rate, you should schedule an evaluation if you notice:

Difficulty biting comfortably

If a dental implant moves slightly when you bite or chew, it may indicate that it is no longer securely attached to the surrounding bone. You may notice that the implant feels unstable, uncomfortable, or different from your natural teeth when eating. Some patients describe a sensation that the implant “gives” under pressure or that their bite no longer feels even. Difficulty biting comfortably should never be ignored, as it may be a sign of implant failure, bone loss, or loosening of the implant or its components. A prompt evaluation can help determine the cause and identify the most appropriate treatment before the problem worsens.

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Swelling or tenderness around the implant

Mild tenderness is common for a few days after implant placement, but swelling or tenderness that develops months or years later is not normal. These symptoms may indicate inflammation, infection (peri-implantitis), or bone loss around the implant. The gums may appear red, swollen, or sore to the touch, and discomfort may worsen when chewing or brushing near the area. Early evaluation is important because prompt treatment may help preserve the implant and prevent further damage to the surrounding bone and adjacent teeth.

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Bleeding from the gums

Healthy gums around a dental implant should not bleed during brushing, flossing or eating. Bleeding may be an early sign of inflammation caused by plaque buildup or a more serious condition such as peri-implantitis, an infection that can lead to bone loss around the implant. If left untreated, the infection may progress and compromise the stability of the implant. Any persistent or recurring bleeding should be evaluated promptly so the underlying cause can be identified and treated before more extensive damage occurs.

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Pus or drainage

Pus or drainage around a dental implant is a strong indication of an infection and should never be ignored. You may notice a small amount of yellow or white discharge, an unpleasant taste or persistent bad breath. These symptoms are commonly associated with peri-implantitis, an infection that can destroy the bone supporting the implant. Without prompt treatment, the infection may worsen and increase the risk of implant failure. If you notice any drainage around your implant, contact your dentist for evaluation and treatment.

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Loosening of the implant or attached crown

Not all implant loosening indicate failure. If the abutment screw loosens, then you notice movement but it is not the implant. That is a good thing and your implant is most likely not failing. However, if all of the bone surrounding the implant has been lost and replaced with soft gum tissue. The implant is no longer supported and moves in any direction.

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Bad taste or persistent bad breath

A persistent bad taste in your mouth or chronic bad breath may be a sign of an infection around a dental implant. Bacteria can accumulate beneath the gums, especially if peri-implantitis has developed, producing unpleasant odors and tastes that do not improve with brushing, flossing or mouthwash. These symptoms are often accompanied by inflammation, bleeding or drainage around the implant. Because infection can lead to progressive bone loss and implant failure, persistent bad breath or an unpleasant taste should be evaluated promptly by your dentist.

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Gum recession exposing implant threads

Healthy gum tissue should fit snugly around a dental implant, covering the entire underlying implant surface. If the gums begin to recede, the metal implant threads may become visible. Gum recession is often associated with bone loss, inflammation, excessive brushing forces or peri-implantitis. Exposed implant threads can make the area more difficult to clean and affect the appearance of your smile, especially in the front of the mouth. Because gum recession may indicate loss of the supporting tissues around the implant, it should be evaluated to determine the underlying cause and discuss appropriate treatment options.

What causes dental implants to fail?

Common causes include:

Peri-Implantitis (Infection)

Peri-implantitis is one of the most common causes of dental implant failure. It is a bacterial infection that affects the gums and bone surrounding the implant, similar to advanced gum disease around natural teeth. As the infection progresses, it destroys the bone that supports the implant, causing the implant to become loose and unstable. Early symptoms may include bleeding when brushing, swollen or tender gums, bad breath, pus or drainage, and gum recession exposing the implant threads. If diagnosed early, peri-implantitis can often be treated and further bone loss slowed or stopped. However, advanced cases may require removal of the implant if there is insufficient healthy bone remaining to support it.

Smoking or Tobacco Use

Smoking and the use of other tobacco products increases the risk of dental implant failure. Tobacco reduces blood flow to the gums and bone, limiting the delivery of oxygen and nutrients needed for proper healing. It also weakens the body’s immune response, making it more difficult to fight infection and increasing the risk of peri-implantitis. Over time, smoking can contribute to bone loss around the implant, delayed healing and failure of the implant to integrate properly with the jawbone. Quitting smoking before and after implant treatment can improve healing and increase the long-term success of dental implants.

Poor Oral Hygiene

Poor oral hygiene allows plaque and bacteria to accumulate around a dental implant, increasing the risk of inflammation and infection. If plaque is not removed through regular brushing, flossing, and professional cleanings, it can lead to peri-implant mucositis, an early and reversible inflammation of the gums. If left untreated, it may progress to peri-implantitis, which causes bone loss around the implant. As supporting bone is lost, the implant may become loose and eventually fail. Maintaining good oral hygiene and attending regular dental checkups are essential for keeping dental implants healthy and maximizing their long-term success.

Excessive Biting Forces

Excessive biting forces can place more stress on a dental implant than the surrounding bone can safely withstand. This may occur in patients who clench or grind their teeth (bruxism), have an uneven bite, or frequently chew very hard foods. Over time, excessive pressure can contribute to loosening of implant components, fracture of the implant or restoration, and gradual bone loss around the implant. Identifying and correcting these forces often with bite adjustments or a custom night guard can help protect the implant and improve its long-term success.

Medical Conditions Affecting Healing

Certain medical conditions can interfere with the body’s ability to heal after dental implant placement, increasing the risk of implant failure. Conditions such as uncontrolled diabetes, immune system disorders, osteoporosis, or a history of radiation therapy to the jaws may reduce blood supply, slow bone healing, or impair the body’s ability to fight infection. Some medications that affect bone metabolism can also influence implant success. Before treatment, your dentist will review your medical history and work with you to help optimize healing and improve the long-term success of your dental implant.

Inadequate Bone Support

A dental implant depends on healthy, adequate bone for long-term stability. If there is insufficient bone width at the time of implant placement or if bone is lost later due to infection, gum disease or other factors, the implant may not be properly supported. In many cases, bone grafting can rebuild the area and provide the support needed for successful implant placement or replacement.

Implant Fracture or Mechanical Failure

Although uncommon, a dental implant or one of its components can fracture or fail due to excessive biting forces, metal fatigue, trauma, or long-term wear. In some cases, the implant itself remains firmly integrated but the retaining screw fractures inside the implant. If the broken screw cannot be safely removed, the implant will no longer be restorable and may need to be removed. If the implant body itself fractures, it cannot be repaired and will also require removal.

How Is a Dental Implant Removed?

The exact technique depends on how firmly the implant is attached to the bone. Whenever possible, specialized implant removal instruments are used to gently reverse the implant from the surrounding bone with minimal trauma. This conservative approach helps preserve valuable bone for a future implant. If the implant cannot be removed using conservative techniques because it is fractured, damaged, or firmly integrated, a small amount of surrounding bone may need to be removed before the implant can be safely extracted.

Trephine Drill

A trephine drill is a hollow, cylindrical surgical instrument used to remove a dental implant by cutting a small ring of bone around it. This technique is typically reserved for implants that cannot be removed using conservative methods, such as reverse-torque removal. Although effective, the trephine drill removes some surrounding bone, which may increase the need for bone grafting before a replacement implant can be placed. Whenever possible, more conservative implant removal techniques are preferred to preserve healthy bone.

Implant Removal Kit (Reverse-Torque Technique)

An implant removal kit is a specialized set of instruments designed to remove a dental implant while preserving as much surrounding bone as possible. The system attaches securely to the implant and applies controlled reverse torque, allowing the implant to be gently unscrewed from the bone without cutting it away. This minimally invasive technique often reduces surgical trauma, shortens healing time. Whenever appropriate, implant removal kits are preferred over trephine drills because they help preserve healthy bone.

How long does implant removal take?

Most implant removals take approximately 30 to 90 minutes, depending on the complexity of the case.

Will I Need a Bone Graft?

Usually, yes but not always. Bone grafting is often recommended after implant removal to rebuild bone that has been lost due to infection, implant failure, or the removal procedure itself. Preserving or restoring bone helps maintain the shape of the jaw and improves the likelihood of successfully placing a replacement implant in the future.

What Happens After Implant Removal?

Once the implant has been removed, the area is carefully evaluated. Typically the area is bone grafted and covered with a membrane to create new bone. This is crucial if another implant is planned to be placed at a later time. The recommended treatment depends on the health of the surrounding bone, the reason the implant was removed and the presence of infection.

Recovery After Implant Removal

Most patients recover similarly to having a tooth extraction. You can generally expect mild soreness for several days, minor swelling or bruising and temporary tenderness. Eat soft foods for several days and allow for gradual healing over several weeks. If bone grafting is performed, healing time before placing a new implant is typically several months.

Can the Implant Be Replaced?

In many cases, yes. After the site has healed and sufficient healthy bone is formed, a new dental implant can often be placed successfully. If bone loss has occurred, bone grafting may be recommended first to rebuild the area and improve long-term success.

Do I Have to Replace the Implant After It Is Removed?

No. Replacing a removed dental implant is often recommended, but it is not always necessary. The best option depends on the location of the missing tooth, your ability to chew comfortably, your esthetic goals, and the condition of the surrounding bone. Some patients choose to replace the implant with a new implant, while others may prefer a dental bridge, a removable partial denture, or no replacement at all. During your consultation, your dentist will explain the benefits and limitations of each option and help you choose the treatment that best meets your functional, esthetic, and long-term oral health needs.

Why Choose Our Office for Implant Removal?

Dental implant removal requires careful planning and specialized techniques to minimize trauma and preserve bone. Our goal is to remove failed or damaged implants as conservatively as possible while maintaining the best conditions for future implant replacement. Using advanced imaging and modern surgical techniques, we develop a personalized treatment plan designed to restore your oral health and maximize the chances of long-term success.

Additional Resources

American Academy of Periodontology – Peri-Implant Diseases
Explains peri-implant mucositis, peri-implantitis, common symptoms, risk factors, and available treatment options.

American Association of Oral and Maxillofacial Surgeons – Are Dental Implants Permanent?
Provides information about implant longevity, reasons implants may fail, and treatment options when implant removal becomes necessary.