Can Dental Implants be Removed?

The short answer is yes - a dental implant can be removed. It is not common, and it is not something anyone plans for, but implants are not permanently fused in a way that makes removal impossible.

It helps to know what an implant actually is. It has three parts: a titanium post placed in the jawbone in place of the root, an abutment that connects it to the visible tooth, and the crown on top. Each can be dealt with separately, and most implant problems involve the crown or abutment rather than the post itself.

Why an implant might need to be removed

Removal is usually prompted by one of these:

• Failed integration. An implant works because bone grows onto its surface, a process called osseointegration. Occasionally that does not happen - the implant stays mobile rather than becoming solid. This shows up in the first weeks or months, and the implant is removed and the site allowed to heal before trying again.
• Peri-implantitis. Infection of the gum and bone around an implant, driven by plaque in much the same way gum disease affects natural teeth. Caught early it can be treated. Advanced cases with significant bone loss may not be salvageable.
• Poor positioning. An implant placed at the wrong angle or depth may be impossible to restore acceptably, or may crowd a neighbouring root.
• Mechanical failure. Rare, but a fractured implant body cannot be repaired - the fractured implant has to be removed.
• Changed circumstances. A significant change in health, or planned treatment such as radiotherapy to the jaw, can alter the picture.

What removal involves

How an implant is removed depends on whether it has integrated.

An implant that has not integrated is usually straightforward. It is mobile already, and removal is often no more involved than a simple extraction.

An integrated implant needs more care, because the aim is to take out the implant while preserving as much bone as possible for whatever comes next. The usual approach is a reverse-torque device that unwinds the implant from the bone - it removes the implant with minimal bone loss. Where that is not possible, a trephine bur cuts a narrow channel around the implant, which removes more bone.

Both are done under local anaesthetic. Recovery is broadly similar to an extraction: some swelling and discomfort for a few days.

What happens afterwards

Removal is rarely the end of the plan. What follows depends on how much bone remains. If replacement options are being discussed, our dental implant versus bridge guide can help you prepare questions for the consultation.

• Healing time. The site is usually left to heal for a period before anything else is done, particularly where there was infection.
• Bone grafting. If bone was lost to infection or during removal, grafting may be needed to rebuild enough volume to support a new implant.
• A replacement implant. Many people go on to have a second implant placed successfully once the site has healed.
• A different approach. Where bone is limited or a second attempt is not appropriate, a bridge or a partial denture can replace the tooth instead.

How to avoid needing one removed

Most implant failures are preventable. Some of it is decided before the implant goes in, and the rest comes down to how it is looked after.

• Proper planning and execution. Correct positioning, and an implant and abutment of the right size for the site, decided from imaging before surgery rather than on the day.
• Regular review if you grind. A patient who clenches or grinds (a bruxer) loads the implant far more than usual and needs it reviewed regularly, and protected with a night guard.
• Cleaning. An implant cannot decay, which leads people to relax about it. The gum and bone around it are still vulnerable, and peri-implantitis is the leading cause of late failure. Brush and clean between the teeth exactly as you would around a natural tooth.
• Smoking. Smoking impairs healing and is one of the strongest risk factors for implant failure, both early and late.
• Regular reviews. Implants need checking and professional cleaning like anything else. Early peri-implantitis is treatable; advanced peri-implantitis often is not.
• Managing grinding. Heavy clenching loads an implant in ways it was not designed for. A night guard protects the restoration.
• Controlling diabetes. Well-managed diabetes is not a barrier to implants; poorly controlled diabetes affects healing.

If an implant feels loose, the gum around it bleeds or is tender, or the crown moves, have it looked at promptly rather than waiting. Almost everything is more treatable early.

The better question: how to avoid removal

Implants can be removed when they need to be, and in most cases something can be put back afterwards. But removal always costs bone and time, so the more useful question is usually how to avoid it: proper planning and execution, the right size of implant and abutment, maintaining hygiene, stopping smoking, protecting against grinding, and having it reviewed regularly.

If you have an implant that feels loose or uncomfortable, or you are weighing implant treatment and want a straight answer about what happens if it fails, Dr. Shipra Jain at Mahavirai Dental and Medical Care in Sector 48, Sohna Road can assess it.