Can New Dental Implants Be Placed In Areas Where Old Implants Have Failed? | Ear, Nose, Throat, and Dental problems articles | Body & Health Conditions center

Dental implants have been around for decades now. Their general success rate is over 90 percent, and most of the major risk factors associated with dental implant failures are known and can be planned for.

Even when everything is done properly, every step of the way, both on the part of the dentist and the patient, a small percentage of dental implants end up failing. The question is, then — what next? Let’s find out.

Why would a dental implant fail?

A dental implant can fail for many reasons. Infection, rejection, or allergic reaction, fractured implant, and implants placed in the wrong direction are among the usual suspect if an implant does have to be removed.

Options for replacing a failed dental implant

All the options that were available to replace a missing tooth before the patient opted to get dental implants will remain on the table. This includes a removable prosthesis, a bridge, or an implant.

In most cases, a patient would like to try for another implant surgery with a few modifications that aim to prevent a reboot of the previous failure. This is why it is important to reassess the case from the very beginning, and try to identify any mistakes that might have occurred during the planning, execution, or the prosthesis fabrication over the implant.

Why did the old implant fail?

Before considering a replacement implant, it is important to determine why the old implant failed. Unless the reason can be pinpointed, the risk that a new implant will join its colleague in failing are extremely high.

If the implant failed due to underlying undiagnosed medical conditions like uncontrolled blood sugar levels, hypertension, or osteoporosis, these conditions should be treated first. Working together with the patient’s physician is important and will allow the dentist to get the needed information about the systemic health of the patient.

Patient habits like cigarette smoking, poor oral hygiene, or neglecting after-care instructions require dentists to counsel their patients — and imparting a sense of shared responsibility towards the success of implant treatment.

Some patients suffer from parafunctional habits like bruxism and clenching their teeth. These should be treated with appliances like night guards.

How is an old dental implant removed?

The ease of removing a failed implant depends on how old the dental implant is as well as the reason for the removal.

A recently-placed implant is easier to remove as not much integration with the bone would have occurred. However, if an implant is older than a couple of years, it would have formed a tight bond with the surrounding bone and firmly set within.

An implant of narrower diameter is more prone to fracture during removal. Longer implants and implants close to vital structures like nerves and the maxillary sinus are also more cumbersome to remove.

If the implant has loosened due to infection of the surrounding gums and bones, or due to failure to fuse with the bone around it, it is quite easily removed using instruments used for extracting natural teeth, as it would have already been mobile inside the bone.

However, if the implant is not mobile, or the screw has been fractured at any level, removing the implant becomes much more complex. To remove a rigid dental implant, the surgeon will start drilling a "trough" around the edge of the existing implant, removing small amounts of bone. This helps loosen the screw within the socket. Then, using a specialized drill, the dentist unwinds the screw, gradually pulling it out.

How soon can a new implant be placed?

Failed implants that were placed in the wrong position, or fractured implants which can be removed with minimum disruption of surrounding bone, can receive a new screw immediately, in the same sitting.

The older site is filled with bone graft and a new implant is selected, which is of a wider diameter compared to the old one, in order to get a better grip in the bone. The implant is placed and the surgical site is closed with sutures.

It is always advised to avoid the immediate loading of a replacement implant as there might not be enough stability to support a prosthesis.

In case an implant has failed due to infection or "peri-implantitis", it is important to first disinfect the site with a thorough cleaning and antibiotic therapy. The site is then filled with a bone graft and allowed to heal.

Follow up X-rays are taken after six months to check for healing. If sufficient healing of the bone is observed, a new implant is placed.

How successful are replaced dental implants?

Studies conducted six functional years after replacement implants were placed show a success rate of over 70 percent. The success rate depends on how well the initial site was disinfected and prepared for the replacement implant.

Conclusion

Dental implant failure is relatively uncommon — but something that every dentist placing dental implants has to deal with. Implant failure is a setback, but not the end of the line for patients. If your implant fails, you are not doomed to be toothless forever.

It is important to first determine why the failure happened. This will help avoid the same mistakes during replacement treatment.

Although success rates of a replaced implant are somewhat lower compared to those of initial implants, it is important to have a discussion with your dentist and proceed with further treatment accordingly.