IMPLANT REVISION PREVENTION
When placing an implant again, we confirm the cause of the previous failure and first decide what to change among bone graft, placement position, prosthesis shape, and thickness.
Why Diagnosis Matters
When placing an implant again, if the cause of the previous failure is not addressed, the same problem may recur. So before placing it again, we first work out why it failed. What we change this time differs depending on whether the cheek-side bone was thin, whether depth, angle, or the shape of the prosthesis was off so that it could not be cleaned, or whether the implant body fractured. After waiting 2-3 months after removal, we look at the bone and prosthesis conditions and set the position, thickness, and length anew as for a first placement, and the existing crown and abutment are not reused but made anew. At Yeonhap Dental Clinic, depending on the cause of failure, we decide what to change among the bone graft, the depth, angle, and abutment design, and the implant size, and then place it again.
Consultation Checklist
At the consultation before re-placement, we use X-rays, 3D CT, an oral examination, and a medical history to work out why it failed, looking at the five items below.
Treatment Options
We divide it into three: sites where bone was lacking, sites where position, prosthesis, or bite was the problem, and sites where the body fractured.
At a site where the implant failed because the cheek-side bone was thin, there is even less bone once the implant is removed. When placing again, if a position that leaves 2 mm on the cheek side can be found, we place it there, but usually it cannot, so we do a sufficient cheek-side bone graft on the same day as placement and do not leave the bone thin.
At a site where depth, angle, or the shape of the prosthesis was the problem, we replan and place the implant at about 4 mm below the gum and parallel, and make a new abutment in a shape that is easy to clean (emergence angle within 30 degrees). If the bite was the cause, we adjust the bite without lateral-force interference. The existing crown and abutment are not reused.
A fractured implant body means its thickness could not withstand the chewing force. After removal and 2-3 months, we look at the previous thickness and the force that site receives and place a thicker size to make up for it. The basic thickness and length criteria for each site remain the same.
Planning Points
We do not place it on the day of removal, and after re-placement we wait 3 months until the prosthesis.
We do not place it on the day of removal. After clearing inflammation during removal and recovering for 2-3 months, we look at the bone and prosthesis conditions and set the position, thickness, and length anew, as for a first placement. After re-placement, we wait 3 months until the prosthesis, and the cost has the same structure as a new placement; if a bone graft or sinus lift is needed, that cost is added.
At Yeonhap Dental Clinic, we advise you to stop smoking for at least one month after surgery, and if quitting is hard, we recommend cutting down sharply at least. After re-placement, we wait 3 months until the prosthesis and advise you to avoid putting excessive force on the surgical site. After the final prosthesis, we check bleeding and gum depth every 6 months.
Before Visit
If you let us know the items below, at the first consultation we can tell you together why it failed and what we will change this time.
Sites where bone was lacking: If a position that leaves 2 mm on the cheek side cannot be found, a sufficient cheek-side bone graft is done on the same day as placement. That is usually the case at a failed site, and we do not do staged surgery in which only the graft is done first. This is Yeonhap Dental Clinic's clinical standard, not a value from the literature. Sites where position, prosthesis, or bite was the problem: Depth and angle are replanned at about 4 mm below the gum surface and parallel to the neighboring tooth, and the abutment is made anew so that the emergence angle (the angle between the long axis of the implant and the prosthesis surface as it flares out) is within 30 degrees. The bite is adjusted without lateral-force interference, and the existing crown and abutment are not reused. Sites where the implant body fractured: We look at the previous thickness and the force that site receives, and make up for it with a thicker size. The basic thickness and length criteria for each site remain the same. Timing and smoking: We do not place it on the day of removal; after 2-3 months we set the position, thickness, and length anew, and after re-placement we wait 3 months until the prosthesis. We advise you to stop smoking for at least one month after surgery, or to cut down sharply if that is hard. The cost has the same structure as a new placement.
In a meta-analysis of 24 studies, the 1-year survival rate of implants placed again at a site where one was removed was 96.7%, but it was lower than for first-time implants, and a second re-placement at the same site was lower still (Gareb 2025). In a Korean study following 69 re-placements, age and smoking significantly raised the risk of repeat failure, all 8 that failed again did so during the bone-bonding period before the prosthesis was attached, and the authors considered patient factors to have a greater effect than implant factors (Park 2022). For implants with cheek-side bone under 2 mm, marginal bone loss one year after prosthesis connection was 0.36 mm, more than 10 times the 0.03 mm for those with 2 mm or more (39 implants, Nohra 2018). For this reason, Yeonhap Dental Clinic confirms the cause of the previous failure and decides which conditions to improve this time. What we change for each cause is as in the criteria above, and we wait 2-3 months after removal and then set the position, thickness, and length anew. Because a revision is a matter of conditions before it is a matter of technique, the same risk continues if the conditions that caused the first failure remain. References: Gareb 2025, systematic review and meta-analysis of implants placed again at failed sites (24 studies; 1-year survival 96.7%; lower than first-time implants; lower still for a second re-placement) · Park 2022, survival and risk factors of 69 re-placements in Korea (age and smoking; all 8 repeat failures were early; patient factors had a greater effect) · Nohra 2018, 1-year marginal bone loss after prosthesis connection of 0.36 mm in the group with under 2 mm of cheek-side bone versus 0.03 mm in the group with 2 mm or more (39-implant prospective study) Treatment results may vary depending on each person's oral condition.
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