Implant Removal And Replacement
Dental implants are becoming more and more widely accepted in the world of restorative dentistry. However, there is a growing problem emerging with dental implants and in some cases the issues that arise require there removal. In most instances, removing a failed dental implant and replacement is a safe and successful treatment. At Dr. Orth’s office, we are well experienced with the latest implantology techniques for these procedures.
Why dental implants fail?
To understand dental implant failure, we have to first understand the types of failure that can occur. In general, there are two classes of implant failures that are based on timing. We have “early failures” that occur within the first few months of when the implant is surgically placed. In these cases, the bone has not formed rigidly around the implant and the implants are usually very easy to remove. In many early failures, the implant is quite loose. This is often due to poor healing ability of the patient, infection, lack of stability when it was placed (not firm enough in the bone) or most likely micro motion (too much movement of the implant during the healing process).
“Late failures” can be considered occurring after a year after the tooth has been in function. In these cases, the implant is firmly anchored in bone, but has accompanying bone loss. This may be due to infection of the gums or too much force on the implant. In most late failure cases, the implant is rigid but X-rays show a pattern of implant disease called “peri-implantitis”, where bacteria has developed and is destroying the bone around the neck of the implant. Peri-implantitis is a growing concern with dentists and patients because it represents an active infection with a dental implant. This infection manifests as sometimes with pain, plus, abscess and bad odor. Measures are required to stop this disease. Unfortunately in many cases, the implant should be removed to prevent spreading pain, infection and further bone loss.
Finally, another reason your implant might need to be removed, if it’s in the wrong position? When it’s in the wrong position, it’s considered a failure because there is trouble restoring the implant into proper function or esthetics. This is highly preventable with proper treatment and planning.
Recent studies from Sweden have been showing that 26% of implants placed 5-10 years ago show signs of peri-implantitis!
Common implant removal methods – techniques
The key is to preserve as much healthy bone as possible in the removal process. Essentially the best tools used to remove an implant would be ones that have enough force to remove an implant without causing significant damage. It is possible to remove an implant in some cases with almost no bone removal. This is the ideal goal and the desired approach. We have a variety of specialized instruments designed to achieve this goal.
Can another dental implant be placed after the failed implant is removed?
In some cases, a new implant can be immediately placed in the site along with a bone grafting procedure to support the new implant. This immediate implant replacement option will save you time and prevent the need for a follow up surgery, which would also save you money.
Most often a failed dental implant can’t be replaced quickly because of the size of bone and gum destruction. Improper removals that end up creating a much bigger hole than the implant fixture make it harder or impossible to replace the implant. Therefore, it is very important to attempt to remove implants in a way to preserve as much bone as possible and to be able to reconstruct the lost bone and gum architecture. Reconstruction of the bone requires specialized bone grafting procedures called “guided-bone” regeneration to regrow new healthy bone and return the natural esthetics of the tissues. Dr. Orth has many years of experience in guided-bone grafting procedures aimed at creating a healthy bone site for the placement of a future implant.
Bone Graft / Bone Reconstruction / Guided-Bone Augmentation
Bone graft is a procedure that is required in cases where you have insufficient bone volume to receive a dental implant after failure. Having sufficient bone mass and a stable implant is critical for long term (years upon years) of success!
Bone grafts are normally used re-establish enough bone to support implants!
Generally, you’ll need 2 mm of healthy, living bone in front and behind your implants. For example, if your implant is 3mm you’ll need (2+2+3), or a total of 7 mm of bone mass. If you’ve had teeth missing for some time and your bone has atrophied to less than the recommended 7 mm, a bone graft will be required. By receiving a stable bone graft the bone replacement and growth that evolves will ensure the longevity and stability of your dental implant.
Infected & Failing Implant Implant Removed & Bone Loss After Bone Grafting Replacement of new Implant & Crown