Can dental implants be removed? Tooth implant removal causes, methods, and post-op care

Matthew Stewart

Written by Matthew Stewart DDS, Benjamin Wang DDS, Jack Lawrence DMD, Peter March DDS

An implant may have to be removed due to a number of reasons. You do have influence over avoiding unnecessary pain and complications. That’s why it’s so important to be aware of the possible risks.

Find out what signs point to dental implant removal and what the aftercare process looks like.

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Causes for removing dental implants

Dental implants on lower arch

Picture by Authority Dental under CC 2.0 license

Failure is the most common reason for removing dental implants. That is often caused by: - infection, - a loose implant, - rejection, - displacement into a sinus, or - impingement on facial nerves.

The first is mostly patient-oriented. An infection can happen due to unsatisfactory oral hygiene or smoking. It is extremely rare for an implant to become contaminated due to malpractice or anything during the placement process.

If the pressure on the replaced tooth is too large, the implant can move. Such a situation is called overloading. This makes proper fusing with the bone more complicated, and the rod can become loose.

The most common reason for implant movement or lack of sturdiness is when an immediate implant is placed in a patient who is not a good candidate.

Peter March

Peter March, DDS

The most predictable way to prevent overdosing implant failures is to allow the bone to fuse to the rod completely. After osseointegration is complete, the dentist can safely put the crown and abutment on.

Rejection can have a number of causes. It can happen due to allergies or a medical condition such as: - rheumatoid arthritis, - lupus, - multiple sclerosis, - type 1 diabetes, - uncontrolled type 2 diabetes, - gum disease - celiac disease, and - head and neck cancer (radiation to the jaws), and - trauma.

Those can be contraindications to placing the implant in the first place. Your dentist will make a thorough examination prior to the procedure to make sure it won’t be a problem. That’s why rejection is not a common motive for removing an implant.

How to remove dental implants?

Dental implant between teeth

Picture by Authority Dental under CC 2.0 license

What the dental implant removal procedure looks like depends on how long it has been in your mouth. The goal is to remove the failed implant while extracting as little bone as possible. The methods differ according to whether the failure is considered early or late.

An early failure means removing an implant that has not osseointegrated yet. For the patient, the procedure looks very similar to the placement surgery. You will go under anesthesia. The dentist will remove the crown and abutment if they have already been placed. The final step is to extract the rod.

The methods include using instruments akin to what is used in extractions. These can be a lever, an elevator, or forceps. Usually, the implant can be simply unscrewed from the bone.

Early failures can happen within 48 hours after placement. The removal process will be similar for implants which did not integrate with the bone properly and remain loose.

Can you remove a dental implant if it has already successfully fused with the jawbone? Yes. But this situation requires more intensive action, which means you might have to be completely sedated.

Choosing the appropriate procedure relies mainly on how much bone is left around the rod. As little as 2-3mm can still hold it pretty strongly.

The most common method is mechanical. An instrument called a trephine bur is used to cut the implant out with a small portion of the bone. A high-reverse torque can unscrew the implant only if there is not a lot of healthy bone left around the implant.

An osseointegrated implant can also be removed with ultrasonic waves. Such a procedure is called Piezo surgery. It is often performed when implants are fractured or mispositioned. The jawbone seems to heal a lot better when ultrasonic waves are used rather than a trephine bur.

The third way is using a laser. This method takes a long time, but it also removes a lot less bone and causes a lot less microcracks than the first technique.

Post-removal care instructions

Dental implant removal aftercare is similar to what was recommended after the initial placement.

Drink only cold liquids and avoid eating until anesthesia has worn off. Try not to touch the affected area with your tongue or fingers. For the first two days you should rest rather than exercise or strain yourself otherwise.

Benjamin Wang

Benjamin Wang, DDS

To reduce the risk of infection and promote healing, your doctor may prescribe you antibiotics. It is crucial to take them exactly as instructed.

Dental implant removal recovery time is about 5 days. You are likely to experience some pain during this time. Take OTC painkillers to manage that. The most difficult step will be deciding how to go about the missing tooth.

Options after dental implant removal

Dental implants in parts

Picture by Authority Dental under CC 2.0 license

Removed dental implant options include dentures or a new implant. Most cases will require bone grafting, which means a replacement won’t be installed until after a couple months of healing.

Benjamin Wang

Benjamin Wang, DDS

Discuss all possible options with your dentist. The most costly option may not necessarily be the best in your case. It is better to have a pair of removable dentures that fit well than to have fixed option that does not function. Your dentist will try their best to accommodate a balance among function, comfort, and esthetics.

A dental implant can be replaced with a new one if the surgical site is free of infection and there is an appropriate amount of bone left. A course of antibiotics and a mechanical cleaning is sometimes undertaken if the area is contaminated.

Dentures are also a common solution. Your dentist may fit you with a full or partial restoration, depending on the situation in your mouth. The gums and bone may have to heal before such dental work can be made. If you want your smile full quickly, you can go for a dental bridge or flipper tooth.

FAQ

It can be. Most experts compare dental implant removal pain to what the patient feels during placement. Some cases are simple enough that removal can be done under local anesthesia. It all depends on how long the implant has been in your mouth.

Removing a dental implant is not always a complicated process. The biggest dental implant removal complications are some pain and discomfort. In extreme cases you may experience bone loss and microcracks in your jawbone.

If removal is necessary, the dentist will review your case to determine what method will cause the least damage.

Dental implant removal cost starts at $500 and tops off around $1,000.

An early failure will probably cost a little less than a late one. This is because the procedure is less severe. The price might likewise be lower if you have your implant removed in the same office you had it placed.

Replacing a failed implant with a new one is often the best solution. It is likely, however, that you will require grafting to make sure your jawbone can support the new restoration.

References

  1. Avoiding implant overload - PubMed
  2. Methods to Improve Osseointegration of Dental Implants in Low Quality (Type-IV) Bone: An Overview - NCBI
  3. Titanium Allergy: A Literature Review - NCBI
  4. Removal of failed dental implants revisited: Questions and answers - NCBI
  5. Factors associated with early and late failure of dental implants - ResearchGate
  6. Risk factors associated with early failure of dental implants. A literature review - PubMed
  7. Risk Factors related to Late Failure of Dental Implant—A Systematic Review of Recent Studies - DOAJ
  8. Utility of Trephine Drills in Implant Dentistry - NCBI
  9. Reverse torque evaluation in indexed and nonindexed abutments of Morse Taper implants in a mechanical fatigue test - ResearchGate
  10. Piezosurgery applied to implant dentistry: clinical and biological aspects - PubMed