Quick Answer
Is implant revision surgery possible?
It is possible. The 10-year implant survival rate is about 96%, but about 22% of patients experience peri-implantitis, and loosened screws or fractured crowns are often resolved by revising the prosthesis. If the implant body itself is loose, it is removed and placed again, and survival rates for re-placement in the same site fall to about 89% for the second implant and about 74% for the third. That is why finding out why it failed first determines the result.
How are the symptoms and causes of an implant needing revision classified?
The symptoms are looseness, gum pus and bleeding, pain when chewing, and a prosthesis that repeatedly comes loose. There are three causes: prosthetic problems with the crown, screw, or abutment; peri-implantitis, in which the surrounding bone dissolves; and failure of osseointegration, in which the implant does not bond to the bone. For a prosthetic problem, only the components are repaired; for peri-implantitis, treatment or removal is decided based on the degree of bone loss; and for failed osseointegration, the implant is removed.
When and how is re-placement done after removal?
After removal, time is allowed for the bone to recover, the remaining bone is re-measured on CT, and the implant is placed again. If the original failure was due to position, angle, or depth, the design is changed. Bringing the date of your previous treatment, the implant manufacturer and size, and recent X-rays or CT scans helps us identify the cause faster.
What criteria does Yeonhap Dental Clinic use to assess implant revision?
In peri-implantitis, Yeonhap Dental Clinic considers removal by looking together at whether more than half of the bone has dissolved, whether the stability value (ISQ) has dropped compared with before, and whether it has failed to recover after three treatments, and does not remove an implant on the basis of any one of these alone. We check the prosthesis emergence angle, shape, and residual cement to see whether the implant can be kept through prosthesis adjustment and gum treatment. We do not re-place on the same day; we re-place after 2–3 months of recovery once the cause has been addressed. After re-placement, we wait about 3 months before the prosthesis. In most cases needing re-placement, cheek-side bone is insufficient; if a bone graft is needed, it is done on the same day as re-placement, and whether and when to reinforce the gum is decided according to your condition. Why peri-implantitis arises from structural factors is explained in the placement depth column.
References
Howe MS, et al. Long-term (10-year) dental implant survival: a systematic review and sensitivity meta-analysis. J Dent. 2019. Derks J, Tomasi C. Peri-implant health and disease. A systematic review of current epidemiology. J Clin Periodontol. 2015. Zhou W, et al. Feasibility of dental implant replacement in failed sites: a systematic review. Int J Oral Maxillofac Implants. 2016. Soulami S, et al. Implant-abutment emergence angle and profile in relation to peri-implantitis: a systematic review. Clin Exp Dent Res. 2022.
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Before Your Visit
This article is general guidance for implant consultations. Whether treatment is possible and the actual cost may change after an oral examination and 3D CBCT diagnosis. If you have discomfort such as pain, swelling, or looseness, please come in for a consultation so we can check.