Dental implant failure: symptoms and how retreatment works
If an implant moves or pus appears around the gum, see a dentist to find the cause. This guide explains repairs to screws and restorations, implant removal and replacement, treatment time and costs.
- If your implant feels loose, have a dentist check whether the implant body in the bone or only the crown above it is moving.
- A loose screw or damaged crown is repaired. If the implant body cannot be kept, the dentist considers removing it and placing another implant.
- Retreatment time depends on the remaining bone and inflammation. A bone graft adds healing time.
- Seek prompt dental care for pus or fever. Go to an emergency department for severe facial swelling or difficulty breathing or swallowing.
An implant has a body placed in the bone and a restoration connected above it. A loose restoration and a body that has not joined to the bone need different treatments.
What symptoms suggest implant failure?
Have a dental examination if the implant moves when you chew, or the gum swells, bleeds or discharges pus. You may also have pain each time you chew, worsening breath or receding gums that expose metal.
Bone around an implant can diminish without pain. Mild pain and swelling just after surgery do not by themselves mean failure, but symptoms that worsen after improving need examination.
Why do dental implants fail?
The joining of bone to the implant is called osseointegration. Failure of that bond before the restoration is fitted is early failure; inflammation or bone loss around an implant in use is late failure. KDCA lists infection, poor oral hygiene, smoking and low bone density as causes of failed osseointegration.
Jeju National University Hospital reviewed records of 17 patients with 26 implants removed during 2013–2018. Thirteen failed before functional loading and thirteen after loading.
Of the 26 removed implants, eleven were in patients with systemic disease and six had been placed with a bone graft. Only failed cases were included, so these counts do not show failure rates for all patients with diabetes or bone grafts.
Heavy grinding or clenching can also cause screw or restoration problems. The dentist checks for loosened or broken components separately from the implant’s attachment to bone.
Does failure always mean replacing the implant?
If the body is firmly joined to bone and only the screw is loose, the screw is tightened or replaced. A damaged restoration alone can also be repaired or remade without removing the body.
Removal is considered when the body is loose or fractured and there is severe bone loss. The dentist checks what is moving and the bone on X-rays, adding CT imaging when needed.
How does retreatment work, and how long does it take?
X-rays or CT first show the inflammation and bone loss, then the implant body that cannot be kept and inflamed tissue are removed. Enough remaining bone may allow immediate re-placement; severe inflammation or inadequate bone calls for treatment and grafting first.
After a new implant is placed, the restoration is attached once it has joined to bone. KDCA describes a general osseointegration period of three to four months; inflammation treatment or grafting before re-placement adds time.
The cause of the first failure also needs attention. Planning includes checking gum care, smoking, grinding and blood-glucose control.
What are the costs and insurance rules for retreatment?
NHIS covers up to two qualifying implants per lifetime for eligible people aged 65 and older. An unavoidable interruption is excluded from that count, and separate coverage rules apply to re-placement during treatment after failed osseointegration.
Insurance coverage for retreating an implant already in use may differ from the original treatment. Request an itemised estimate for removal, peri-implantitis treatment, grafting and re-placement, and ask which items are covered.
Check whether the original clinic’s warranty applies too. The amount you pay depends on which treatments it covers as well as how long the warranty lasts.
What does the dentist examine?
These findings help determine whether to repair components, treat inflammation or remove the body.
| Item | Tell your dentist | What is examined | Before the visit |
|---|---|---|---|
| What is loose | What moves when chewing | Stability of the body and restoration | Do not wiggle it to test it. |
| Gum inflammation | Bleeding, pus and swelling | Inflammation and surrounding bone loss | Seek prompt care for pus. |
| Pain | When it started and how it changed | Pain when chewing versus at rest | Give the name of any pain medicine used. |
| Imaging | Previous X-rays | Bone changes compared with earlier images | Bring records from other clinics if available. |
| Screws and restoration | Previous loosening or breakage | Component replacement and bite adjustment | Keep any detached part and bring it. |
| Health and habits | Diabetes, medicines, smoking, grinding | What needs management before treatment | Mention osteoporosis medicines and injections. |
| Costs and warranty | Past treatment and warranty documents | Insurance coverage and warranty scope | Ask about grafting and restoration costs too. |
What to verify
Questions for your dentist
- Is the body in the bone moving, or has only the restoration loosened?
- Did it fail to join to the bone, or did inflammation develop during use?
- Does the body need removal, or can it be repaired or the inflammation treated?
- Do I need a bone graft before another implant is placed?
- Can you place it on the removal day, and how long until the restoration is finished?
- What caused the first failure, and how will it be treated this time?
- Do any medicines or smoking habits need changing before treatment?
- What are the separate costs for removal, grafting, a new implant and the restoration?
- Do my original clinic’s warranty and health insurance apply?
- Who should I contact if a problem occurs after treatment?
If an implant feels loose, do not move or tighten it yourself; have a dental examination. Explain when the trouble began and bring earlier treatment records or detached parts if you have them.
FAQ
FAQ
Does no pain mean my implant has not failed?
Inflammation can reduce the surrounding bone without causing pain. Have swelling or bleeding gums checked even if they do not hurt.
Does a loose screw mean I need another implant?
If only the screw is loose and the body remains attached, the screw is tightened or replaced. Repeated loosening also calls for checking grinding, clenching and force concentrated on the restoration.
Will peri-implantitis go away on its own?
Have it treated rather than waiting for it to settle on its own. Inflammation initially confined to the gum can spread to bone and reduce the bone supporting the implant.
Is retreatment more painful or difficult than the first surgery?
Adding grafting or inflammation treatment increases the treatment area and healing time. Whether pain is worse depends on the procedure, anaesthesia and postoperative medicines.
How much longer does grafting make retreatment?
It depends on how much deficient bone needs rebuilding. Grafting may accompany implant placement, or be performed first with a healing interval before placement.
Can I leave a failed implant in place?
If there is inflammation or movement, discuss removal and treatment timing with your dentist rather than leaving it untreated. Do not tighten screws or try to wiggle the implant out yourself.
Does health insurance cover implant retreatment?
Coverage rules differ between re-placement during treatment after failed osseointegration and problems after the completed restoration has been used. Ask separately about coverage for body removal, inflammation treatment and re-placement.
Does a loose implant with pus need prompt dental care?
Contact the clinic that placed it or a nearby dentist for prompt care. Go straight to an emergency department for severe facial swelling or difficulty breathing or swallowing.