Dental Implant Failure & Salvage

Dental implants are successful in more than 95% of cases, but not every outcome remains stable, comfortable or esthetically acceptable over time. If you ever suspect a problem with one of your implants, contact our dental team right away.

Not every implant problem requires removal
Second opinions and implant rescue
Prosthetic, biological and mechanical causes explained
Experience with complex revision cases

Prof. Dr. Wael Att, a board-certified prosthodontist, former chair of prosthodontics at Tufts University School of Dental Medicine, author of 170+ publications and co-developer of the STAR Concept with David Norré, approaches implant problems by identifying the real problem before recommending removal or replacement. Our goal is to address it in the most efficient and conservative way possible.

Request an Implant Evaluation or Second Opinion or call (617) 236-5969.

Symptoms and Causes

Implant problems usually have one or more of four kinds of cause:

Biological. The most common culprit is an infection known as peri-implantitis: harmful bacteria beneath the gumline attack the tissue around an implant until it can start to lose its base of support. Missteps in oral hygiene can be a major contributor. Medical conditions such as uncontrolled diabetes and certain types of cancer, and smoking, can also affect implants.
Mechanical. Implants do not have the cushioning ligament that natural teeth have, so severe teeth grinding, an unbalanced bite or a sudden accident can lead to bone loss or a fractured restoration.
Prosthetic. Ill-fitting crowns, poorly designed emergence profiles, excessive cantilevers on full-arch restorations and cement left beneath the gum are common contributors to late problems.
Surgical. Implants placed in insufficient bone, at suboptimal angles, too close to adjacent teeth or without enough initial stability are more likely to fail early. In some cases an implant does not successfully bond with the surrounding bone (failed osseointegration).

Problems can appear days, months or even decades after placement, so monitor your oral health and seek an assessment at the first sign of trouble. Symptoms that deserve attention include:

Pain. After you heal from dental implant surgery, your new teeth should function without pain. Severe or unusual discomfort deserves professional attention.
Inflammation. Swelling, redness or pus could point to peri-implantitis.
Bleeding. Bleeding around an implant is the earliest sign of peri-implantitis and should not be ignored.
Mobility. An implant feels loose. This could be a problem with the implant itself or the restoration on top of it.
Esthetic recession. The gum recedes around an implant and changes how it looks.
Hygiene difficulty. It is hard to keep the implant and its restoration clean.
Phonetic issues. Changes in how you speak.
Chewing problems. Once you get used to your implants, it should be easy to eat a wide variety of foods. Challenges here can be a red flag.

You May Not Need Implant Removal

An implant problem does not always mean the implant has lost its integration with the bone. Often the real issue lies elsewhere, and prosthetic problems in particular can be redesigned.

Possible underlying issues include:

Prosthetic design. The crown or bridge on the implant may be the source of the problem.
Occlusal overload. Excessive or unbalanced biting forces on the implant.
Soft-tissue deficiency. Not enough healthy gum tissue around the implant.
Cleansability. A restoration that is difficult to clean around.
Tissue architecture. The form of the gum and bone around the implant.

Treatment Options

Dental problems tend to get worse over time. If you delay treatment for a problem with one of your implants, you could end up needing more extensive (and expensive) care.

When you arrive for your appointment, we will learn about your symptoms, examine your mouth and use advanced imaging to look beneath your gumline. Then we can propose a treatment plan. Depending on the cause, options include:

Non-surgical management. Sometimes care is relatively simple, such as a course of antibiotics.
Prosthetic redesign. A new or redesigned restoration on the existing implant.
Soft-tissue or bone intervention. Peri-implantitis caught early can be treated with surgical debridement and sometimes regenerative therapy.
Implant removal and replacement when the prognosis is poor. A failing implant can often be removed and the site regenerated. After a recovery period and additional restorative care, you might be eligible to receive a new implant.

Our practice handles implant failure salvage and revision cases from across New England. Read why patients travel for complex care, how we use predictive planning, and our full-arch second opinion guide. If you are looking for help with implant failure in Boston, we are here to give you a clear answer.

Concerned your implant has failed? Request an Implant Evaluation or Second Opinion or call (617) 236-5969.

Referring doctor? Submit a complication or revision case, or call (617) 236-5969 to arrange a secure transfer of records.

Getting a Second Opinion: What to Bring

CBCT scan. Your most recent 3D scan, if you have one.
Implant system details, if known.
Prior treatment plan. The plan you were given for your implant treatment.
Symptoms timeline. When your symptoms started and how they have changed.
Photos. Any photos of your smile or the implant area.
Records. Your dental records. Bring them to your appointment, or call (617) 236-5969 to arrange a secure transfer.