Can an Old Dental Implant Be Replaced? What to Know
Dental implants have a well-documented record of long-term survival, and the majority placed decades ago are still in service. That is worth stating first, because discussions of failure can give a misleading impression of how common it is.
Nevertheless, implants are not permanent fixtures in the sense of being immune to problems. They can lose bone support, fracture, become chronically infected, or become unrestorable. When that happens, removal and replacement is often possible.
The process is more involved than placing an implant into an untouched site, and it is worth understanding why.
Can an Old Dental Implant Be Replaced?
If my implant fails, can another one go in the same place?
Often yes, though not always immediately. The determining factor is the condition of the bone after the old implant is removed. Where removal is atraumatic and enough healthy bone remains, a new implant can sometimes be placed at the same appointment. More commonly, particularly where the implant failed because of peri-implantitis and bone has been lost, the site needs grafting and a period of healing — often several months — before a new implant can be placed. In some cases the bone deficit is such that an alternative restoration is more sensible than persisting with an implant. Replacement is usually achievable; the question is what preparation is required first.
Why an Old Implant May Need Replacing
Peri-implantitis. Inflammatory disease around the implant with progressive bone loss. This is the most common biological cause of late failure. Contributing factors include inadequate cleaning, smoking, poorly controlled diabetes, a history of periodontal disease, and residual cement from cement-retained crowns.
Late loss of integration. The bone-implant interface fails, and the implant becomes mobile. A mobile implant is a failed implant and cannot be salvaged.
Implant fracture. Uncommon but not unknown, particularly in narrow implants under heavy load, or in patients who grind. A fractured implant body generally requires removal.
Component damage. Stripped internal threads or a fractured screw retained within the implant may render it unrestorable even though the implant itself is integrated.
Malposition. Implants placed at an unfavourable angle or position, sometimes decades ago before three-dimensional planning was routine, may be impossible to restore acceptably.
Obsolete design. Some older implant systems are no longer supported, and matching components may be unobtainable. An otherwise sound implant can become unrestorable for this reason alone.
Changed circumstances. Adjacent tooth loss or a change in the restorative plan may make an existing implant unsuitable for the new design.
How an Old Implant Is Removed
Technique has improved considerably, and the priority is conserving bone.
Reverse torque. A device applies rotational force to unscrew the implant. Where integration has partially failed, this can remove the implant with minimal bone loss and is the preferred approach where feasible.
Trephine removal. A hollow cylindrical bur cuts around the implant. Effective but removes a ring of bone, creating a larger defect. Used where reverse torque is not possible.
Piezoelectric surgery. Ultrasonic instruments cut bone selectively while being less traumatic to soft tissue, and can be used to loosen an implant with good bone conservation.
Surgical flap access. Where the implant is deeply placed or fractured, raising a flap gives access, sometimes with removal of a small amount of overlying bone.
Removal is carried out under local anaesthetic, with sedation available where appropriate. Most patients find the experience less difficult than they anticipate, though discomfort and swelling afterwards are usual for a few days.
Bone Condition and Replacement Planning
What is found after removal governs everything.
Where the defect is contained and the surrounding walls are intact, grafting is more predictable. Where a wall is missing, reconstruction is more demanding and may require membranes, block grafting, or other techniques.
Grafting materials include the patient's own bone, processed human donor bone, animal-derived mineral, and synthetic materials. Each has different handling and resorption characteristics, and the choice depends on the defect.
Healing time before placing a new implant is commonly in the region of four to six months, sometimes longer for larger grafts. This is not a delay that can be usefully shortened.
A cone beam CT scan is normally taken before and after to plan accurately.
Factors Influencing Suitability
• Smoking, which substantially increases the risk of repeat failure and of graft complications
• Diabetes control, which affects healing and peri-implant health
• History of periodontal disease, which is associated with higher peri-implantitis risk
• Grinding and bite forces — see teeth grinding
• Oral hygiene, which is the most modifiable factor and the most important
• Reason for the original failure — if it is not identified and addressed, recurrence is likely
• Medications affecting bone metabolism, which require careful medical liaison
• Available bone volume and proximity to anatomical structures
The point about identifying the original cause deserves emphasis. Replacing an implant that failed from peri-implantitis, without changing the hygiene, smoking, or maintenance situation that produced it, invites the same outcome.
What Replacement Involves
A typical sequence: assessment with imaging, removal of the failed implant, grafting if required, a healing period, placement of the new implant, a further integration period of several months, then restoration.
Provisional replacement of the tooth during this time is usually possible — a removable temporary, an adhesive bridge, or an existing prosthesis modified. You should not be left with a visible gap for months without discussion.
The overall timeline is often nine to eighteen months from removal to final crown where grafting is needed, which is considerably longer than a straightforward first-time implant. Anyone considering this should have that timeline set out clearly at the start.
When to Seek Professional Advice About an Existing Implant
Arrange an assessment if you notice:
• Bleeding when cleaning around an implant — see bleeding gums
• Redness, swelling, or tenderness of the gum around an implant
• Discharge, a bad taste, or a persistent odour
• Any sensation of movement in the implant or its restoration
• Gum recession exposing the implant surface
• A change in how the restoration meets the opposing teeth — see bite feels off
• The crown becoming loose or coming off
Early peri-implant inflammation confined to the soft tissue is reversible. Once bone is lost, it is not. This gap between the two is the reason review appointments matter.
The NHS provides general information about implants at nhs.uk/conditions/dental-implants/.
Extending the Life of Your Current Implant
• Clean daily around the implant with correctly sized interdental brushes
• Attend hygiene appointments at the interval recommended, often three to four monthly
• Attend check-ups with periodic radiographs so bone levels are monitored
• Stop smoking — this is the single largest modifiable risk factor
• Wear a night guard if you grind
• Report bleeding or any change promptly rather than waiting
• Keep neighbouring teeth periodontally healthy
Key Points to Remember
• Most implants serve well long-term; failure is the exception
• Peri-implantitis is the commonest biological cause of late failure
• Bone condition after removal determines whether immediate replacement is possible
• Reverse torque removal conserves the most bone where it is feasible
• Grafting typically requires four to six months of healing before replacement
• The original cause of failure must be identified and addressed
• Overall replacement timelines are often nine to eighteen months where grafting is needed
Frequently Asked Questions
1. How long do dental implants usually last?
Long-term studies report high survival rates over ten years and beyond, with many implants serving for decades. Outcomes vary with the individual, the site, hygiene, smoking, and maintenance, so figures should be read as averages rather than expectations for any one person.
2. Is replacing an old implant harder than the first placement?
Generally yes. The site has been altered, bone may have been lost, and grafting is often needed. It is a more involved process with a longer timeline, though it is routinely achievable in appropriate cases.
3. Can a replacement implant fail too?
It can. Replacement sites carry a somewhat higher risk than virgin sites, and if the original cause of failure persists, the risk is higher still. Addressing hygiene, smoking, bite forces, and medical factors improves the outlook considerably.
4. Will I be without a tooth during the process?
Usually not visibly. Provisional options — a removable temporary, an adhesive bridge, or a modified existing prosthesis — are normally arranged. Discuss this at the planning stage so you know what to expect.
5. Is removing a failed implant uncomfortable?
It is carried out under local anaesthetic, and most people find it more manageable than anticipated. Some discomfort and swelling for a few days afterwards is usual and is managed with routine pain relief and post-operative instructions.
6. Could something other than an implant be a better option?
Sometimes. Where bone is severely deficient or repeat failure is likely, a dental bridge or a removable prosthesis may be a more sensible plan. This should be an open conversation rather than an assumption that another implant is the only route.
Conclusion
An old or failing implant can usually be replaced, and the techniques for removing implants while conserving bone have improved considerably. What varies is the preparation required, and that depends almost entirely on how much bone remains once the old implant is out.
The more useful message is preventive. Peri-implantitis develops gradually and often without pain, and the window in which it can be reversed — while inflammation is confined to soft tissue — closes once bone is lost. Regular review and daily cleaning are what keep an implant in that window.
If you have concerns about an existing implant, you are welcome to book an appointment at Wimpole Dental, 22 Wimpole St, London W1G 8GQ, or call 020 7183 0692. You can read more about dental implants on our website.
Dental symptoms and treatment options should always be assessed individually during a clinical examination.
Dental Disclaimer
This article is for general educational information only and is not professional dental advice, diagnosis, or a treatment recommendation. Information here is general and cannot replace an in-person assessment by a qualified, GDC-registered dental professional. Symptoms, suitability, fees, timelines, and outcomes vary according to individual clinical circumstances. If you have pain, swelling, or other concerning symptoms, seek prompt professional dental care. Always request a written treatment plan and cost estimate before proceeding with treatment.
Written Date: 19 August 2026
Next Review Date: 19 August 2027
Written by Dr Yasha Y Shirazi · reviewed by Dr Yasha Y Shirazi, GDC 195843
This article is general information, not personal clinical advice. For a diagnosis and a plan tailored to you, book a consultation with a GDC-registered dentist.
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