About 30% of what I do is actually remove and replace failing implants.
There are a couple of different ways implants can be removed: can the whole implant be removed out of the bone? And, can the crown from an implant be removed?
There’s a lot of work that goes into removing implants and in this video, I go into detail about what needs to happen in order to remove either the crown or the entire implant.
The procedure is involved and requires an experienced dentist as you’ll learn when you watch the video.
For more details watch the video below and if you have questions or comments, please post them below and subscribe to my channel to get more information about dental implants.
Can my dental implants be replaced or removed?
Video transcript lightly edited for easier readability.
The question today is can dental implants be removed? Interesting topic. About 30% of what I do is remove and replace failing implants. My practice is pretty unique as an implant-only practice in Southern California.
So, there are many different ways that implants be removed and it can mean a lot of different things – can the whole implant be removed out of the bone? Can the crown be removed? Let’s talk about both things. Let’s start with the simple part. Can a crown from an implant be removed? That’s the part that you see in the mouth.
So, a crown can either be uncemented or unscrewed, usually, as long as the implant has a screw on it. You can break the cement seal, you can drill a hole in the top of it and get to the screw called the abutment screw and hopefully unscrew it out, leaving the implant below. You would need that if you were having a new crown put on, it chipped, it broke, you’re trying to go attach that implant to another implant, or using it for a different purpose.
Some problems can be encountered, as sometimes the screws are stripped. Sometimes the dentist doesn’t know the kind of screw that was used or doesn’t have the right tool. Or, the abutment gets stuck because a friction lock type of abutment doesn’t actually just come off by unscrewing. It has to be pulled out of there. So removing crowns can be a little bit tricky to get out, but usually, it’s straightforward as long as the previous dentist set it up to get it out all right, and the current dentist knows what they’re doing and is familiar with implant dentistry because there are lots of different, proprietary screws. Gosh, I have so much stuff in my office. You can’t even believe all different types of screwdrivers and things to fit.
Also sometimes you have to remove the abutment as well. That’s the next level down. That requires special screwdrivers and oftentimes special tools to get that part out, to then get down to the implants. So let’s say the whole implant needs to be removed. Yes, it can. That’s inside of the bone. If the implants are loose because they’ve failed, then taking them out is pretty easy. It’s like taking out a tooth on one of my children. They’re loose. They move from side to side, and they come out pretty easily. They do bleed a lot when they come out.
Let’s say an implant has to come out that has half its bone still there or all of its bone. They don’t come out very easily, especially in the lower jaw. So, what are the methods to remove an implant?
Ideally, you can take off the crown, put something inside it, and just reverse it out. We call it reverse torquing. If it’s really stuck in there, bone has to be removed or something called a “trephine” which is like a hole saw, to make it like a hole for a door to put in a doorknob. You have to drill a hole around. It’s invasive and destroys a lot of bone, so removing an implant can be a very destructive process.
Sometimes a new implant can be placed on the same day, always has to be a little bit wider or a little bit longer, but oftentimes it’s best to wait a little while or to do a bone graft and come back to it another time. Sometimes the implants are very deep. They’re close to nerves and the bottom jaw or they’re close to the sinuses and you can perforate a hole or make an injury to the nerve.
Oftentimes it’s better not to replace it on the same day. To remove a full arch, let’s say an all on four that’s failing, we would have to unscrew the whole bridge and then I would take out the abutments and then get each of the implants out. Sometimes I can use some of the existing implant. Sometimes they’re not deep enough, but again, can implants be removed? Certainly, yes they can.
On the upper jaw, it’s a little bit easier since the bone is softer, especially because that bone is not as high density. We call it cortical bone. If a lower, full mouth replacement needs to come out and the implants replaced, oftentimes there’s a lot of tissue loss or gum loss that came along with it as well as bone loss. Oftentimes the new implant and the level of bone is less than when it started.
Also, you have to be careful when removing implants, not to damage adjacent teeth, but say if the implants are placed between two teeth like this and there’s very little space, you can damage a tooth on either side.
Certainly, somebody with a lot of experience should be removing implants, especially if it’s something that’s integrated well. About half the cases I do and I’m doing a full mouth replacement includes at least one implant removal. Sometimes it just can’t be used with the other implants if I’m going to group one tool to others, but yes, implants can be removed.
Hopefully yours don’t have to be. We’ll go deeper into this topic at a later date.
Your questions and comments are welcome. To see more videos like this, please subscribe to my YouTube channel.
I typically can’t afford for a crown I don’t know what to do I’m stuck on the situation and if I pay in payments it’s too much and it leads me with no money I won’t be able to buy food I won’t be able to buy nothing for myself and my price cuz it’s all going to go to that what happens if I just pull it out because that’s what I’m going to do today I’m going to I’m going to pull out the implant I don’t care what happens if my teeth they fall out they fall out oh well cuz I’m done I can’t too expensive for
Hello Dr. I posted a few months ago on here about my malocclusion and what it was doing to my implants and teeth. Update is not good. The practice that did the work decided to blame it all on PDAP, although their last examination of me showed shim stock not being held at all by the molars and premolars. I went to a dentist who was a personal friend who felt he could do some slight adjustments and it would be fine. Except he burred down every tooth and all 10 crowns and now I have an unrecognizable mouth. He left me with no bite, and flattened my molars to completely smooth. Now my incisors are getting all the bite, I can’t chew, and I see my gums thinning and receding everywhere. I am lost now. I can’t believe how badly this has gone and I see no path forward except to replace all 10 crowns and now also crown my canines which were reduced and re-shaped. I guess my question is would it be worth it to just get all of it removed at this point and get dentures? For a year now my poor implants and teeth have been getting injured by bad angles, misalignment, etc. I went to a prosthodontist who wants almost $50K to replace just the 10 crowns, then $2400 per crown for my natural teeth. I can’t afford all this work after what I spent to get the 10 originally. It’s a mess. No provisionals were done, I didn’t pick the right practice twice now and I am sick over it. Any ideas? I would move to Burbank and see you for rescue if I had the money. It has robbed me of any hope.
PDAP?
Don’t get dentures! Gosh no.
See an orthodontist if you need some slight correction of the bite!
😃
The crowns are on implants
Doctor, it’s crowns over implants that were burred down and don’t meet or chew
Dear Dr. Amin,
If this is a duplicate post, I apologize. I have pain in implants 23 and 26 which have a cement retained bridge. There is 3 mm bone loss around both implants, the abutments are showing, and the gums are tender. There is no BOP and no pus. The implant bridge is not moveable. The pain is getting progressively worse. I’ve been told that flap surgery with debridement carries the risk of even more bone loss. Can a bone graft be done at the same time, or is it better to have the implants removed? From reading your posts, it seems dependent on what kind of bone defects are present. I would like to save the implants, but if that is not possible I would like to try to have them replaced, but I have osteopenia. I’m not taking bisphosphenates. Your expert opinion would be appreciated. Thank you for this blog. You’ve reassured so many people.
I think I replied already???
Are you a dentist?
Dear Dr. Amin,
My implants are 10 years old. They are on #23 and #26 with a cement retained bridge. a gingival tunnel graft was recently done with the intent of getting more blood supply to the area. Unfortunately, the pain is persisting. I would like your opinion on open flap surgery to debride the implants versus remove them and try again.
Give it 6 -12 months before doing anything 😉
Dear Dr Amin,
I’m having increasing pain on two lower implants with bone loss. I’ve heard that open flap debridement can cause even more bone loss. Can a bone graft be done at the same time the implant surface is being decontaminated? What is the success rate of this procedure? Is it better to have the implants removed? I have to consider the cost of these procedures, time off of work, not to mention the pain involved. I know it’s difficult to comment without X-rays, but I would welcome your expert input. Thank you very much for this blog. You have helped many people.
How old are the implants? Which teeth are they?
Dear Dr. Amin,
I have 10-year-old implants on 23 and 26. The crowns are cement retained. I am having gum sensitivity, bone loss 2-3 mm, and the abutments are showing. There is no BOP and no pus. I had a tunnel graft procedure recently to try to conservatively manage these conditions, however, I am still having pain around both implants, which is getting worse. I don’t know if I should have a flap regenerative procedure, or just remove the implants and try to get new implants. From what I understand, a lot depends on where the bone loss is around the implant.
Also, I just learned that there is bone loss around implant 30 that was placed 1.5 years ago, so fairly recently. It’s a 8 mm Straumann implant, and the bone loss appears on one side. Tooth 31 has mobility and some minor bone loss, and tooth 29 has a root canal and a post and crown. That tooth has been hurting for 2 years. I’ve thought about extracting it numerous times, but the oral surgeon said he cannot replace that tooth with a bone graft and implant because it’s too close to the nerve. I’ve seen many specialists about tooth 29, and cbct scans show nothing that would cause pain. There doesn’t appear to be a fracture. Perhaps it’s an occlusal problem or receding gums, or both. I would appreciate your opinion on these 3 implants. As you know, the money, time, and physical burdens are important considerations.
Please post a picture to a public Google Drive. That would be about the only way that I can really comment on these specific implants. I feel like I am seeing your name before and other comments. Have I answered other questions for you already?
Dear Dr. Amin,
Yes, I have asked for your advice more than once recently. I’m in a tough spot, but I did see an oral surgeon in Sacramento who had some good insight into my complex case. Thank you for reading my emails and for helping so many people. Your front office staff is very helpful as well.
Hi- I was just told my implant on tooth #3 needs to be redone as some of the bone graft around it is soft? Anyway if I decide to do nothing, can I leave the implant there?
The bone loss will become progressive in many cases and can damage the adjacent teeth!
Hello Doctor Amin. I wish I lived closer to CA because I need help and have been following your posts for quite a while- you are awesome! Anyway, I had a bunch of implants placed, and crowns. Are for molars and premolars. Individual, no bridges. I had a history of gum disease before but the doctor only did regular cleanings prior, during, after. The occlusion is off, we changed some crowns, the occlusion is still off, they are saying it is fine. It can’t be fine, I feel where things hit first, what is hitting too hard, and my gums and bone are receding over my real teeth as well as the implant crowns. My front teeth have been aching. I have been back and forth with this practice for many months trying to get it fixed and they say I am in maintenance now, just get a cleaning every three months and the hygienist will alert the doctor if anything looks off. I am so confused and disappointed. Now I even have a lingual bar over my bottom anterior teeth because they are loose, which I had no issue with prior to crown placement. It’s hard to get an honest opinion here as all of the doctors know each other, I got several second opinions. One doctor who is not intimidated did a t-scan on my bite and said it is way off, causing abfractions, chipping teeth, etc. But he wanted to do two sets of new crowns and besides the money I’m not sure my mouth can handle so much more trauma. Right now all of the implant crowns are showing black at the gum line, there is swelling in my upper gums, and roots are showing on my natural teeth where they were covered six months ago. I don’t know if it is from my mouth trying to find a comfortable bite and clenching. But I never find anything that feels good, my lower jaw has to tense up to get the crowns and teeth to meet. Do I stay the course with this practice or do I cut and run? I spent a ton of money on this and it has me so depressed and scared that I will lose all of it. I was told I have 50% bone loss around my natural teeth now. It’s been a nightmare. Like I said if I was in CA I would see you but that’s a pretty far trip for multiple appointments and procedures. I feel like it’s destined to fail 🙁
Oh gosh! Jeez! Sounds like a MESS! I would need to see you to manage and help you on this. A complex case he is usually managed in the transitional/provisional phase. Once the bite is worked out it is then duplicated digitally into the new final teeth. This is how I do it and it is very reproducible and has no surprises. I am sorry you are going through all this.
Maybe all teeth should have been extracted instead?
The teeth I had before we started were not loose and had a fair amount of gum tissue. My bite is hard in the front of my mouth which is why I guess they are suffering. They did not do provisionals, in fact the first follow up was two weeks after crown placement, then three weeks and then they sent me an article about how people who think their bite is too anterior suffer from a psychiatric disorder. I would love to have you assess and treat but I live on the east coast. What am I going to do?
Also they left two mis-shaped premolars on one side and tried to make the crowns above them fit like a puzzle piece, with a slot in one of them to allow the lower high side to slip in. One side of my mouth meets up and down and the other sort of slides in and out. I am terrified what the end result of all this will be in short time. They have basically kicked me to the curb, and act like I am bothering them when I tell them what I am feeling and seeing going on. How many times would you have to see a patient like me to straighten this out? Like I said I live far away and don’t know how I would manage to make trips back and forth
You need to be seen locally. It sounds like there is a lot to work out
Ok. How much more trauma can a mouth go through? Can I successfully get new crowns without losing the rest of my teeth, bone and gums? Or is it going to be too much to go through that again?
These are questions I can not answer without seeing you.
I have an all on 6 upper that was cemented in now it is loose on my right side it’s still cemented on my left side this is causing me pain and discomfort but no dentist will help me they’re afraid of damaging the implant what should I do
There are very few dentist that can handle this. Just spend the time to find somebody who has the skill and experience to do this. Keep in mind that it might break and need to be replaced. You have to be realistic. What you are describing is worse case scenario when one side is cemented and the other side is still attached.
When are cantilever implants used?
I’m a 58 yr old female w mild case of RA & sjogrens. My #5 & 6 root canaled teeth fell out, both have been bone grafted. One Peridontist wants to do only 1 implant on #6 & 2 crowns off of #6. #5 he says doesn’t have enough bone: would need a sinus lift and a bone augmentation even after having done the first bone graft.
Is this a recipe for disaster bc too much force will be placed on #6?
Do cantilevers last 10-20 yrs?
They are most often used to cantilever 7 from 6 or 10 from 11. They are also used for full arch implants. These are the two best scenarios to be used with high predictablity.
I have had an all on 4 procedure on my upper I am very unhappy with this procedure can this be reversed to except another procedure
Ugh…so sorry. Give me more details. Correcting things gone wrong is a huge part of what I do. Yes…it can be reversed/corrected. There is so much to a full upper fixed bridge.
https://burbankdentalimplants.com/category/full-arch-implants-all-on-4-5-6-7-8/ here are 50 articles and videos on the topic
To start off one of the implants is very close to a nerve whice I can feel by pressing against my lip whice I have told them and all I get is only if it starts to cause you pain will we address it further ,The new Dr had placed the implants basically to bypass sinus lifts whice he could not done and was told everything would say the same other then not having sinus lifts not at all true this is when I found out I was getting the all on 4 ,sinus lifts was the original Dr’s plan so that I could recieve a different procedure of a full arch using my own gum line instead of zirconia.
Hi Dr. Amin,
I had four bicuspid implants placed years ago. I’m in my 20’s and have chronic migraines, and several ortho specialists have said the migraines (among other things like poor posture, nasal canal breathing issues) are due to the fact that all of my teeth are placed far back into my mouth. I’ve only met with one oral surgeon, but they said they wouldn’t take the four implants out so my teeth and jaw can move forward.
Do you know of anyone who could do this procedure or has done something like this before? I can imagine it’s incredibly invasive, and maybe not even possible.
Thanks!
It is not that difficult to remove implants but that the long shot to go through all this process to deal with chronic migraines. I would see a migraine specialist and work on preventative medications, possibly manage bruxism with Botox and understand how to use fast acting medications such as Imitrex/Rizatriptan. You could end up going through all of this dental work to end up with nothing different than what you started. I think this is a tremendous risk with a lot of assumptions. I have a family member close to me that has chronic migraine so I do understand this quite well and do not take it lightly
I have an implant over 20 years and it never felt right. In the last couple of years it has been hurting me. It is in the lower jaw and it is fused to the bone. I have bone loss there also. It is right near my nerve. I am constantly in pain. Whst do I do?
Unfortunately-the implant may be failing. It might be able to be rescued with a bone and/or gum graft where it might just need to be removed and replaced. It is okay that it is fused. A skilled practitioner will be able to remove it safely. This is certainly something for the more experienced dentist rather than somebody who is very new to removing an implant. After you have it removed you can have another one put back in for another 20 years!
My wife’s 20 yr old implant (#19) needed to be removed due to infection but was fused and the adapter bit was broken off while trying to reverse torque (now stuck in abutment.) Dr then used trephine method but eventually stopped and said it was just too close to the facial nerve. He sutured the gum over the abutment. His plan now is to allow the gum to grow over the abutment. She did not want another implant placed. Have you ever heard of this. Basically he wants to “bury the implant” and leave it there much like titanium plates/screws used for other surgeries (knee/hip/foot etc. ) Your thoughts on this matter would be most welcome. Thank you
Yes that is a safe method….but if it is truly #19, I doubt that it is too close to the nerve to remove. You should reconsider another implant as #19 is a very important tooth for longevity!
Hello Doctor,
I was born with no right lateral incisor. I have visited many doctors and they were suggesting either I go for the implant or just put braces on and shape my canine into a lateral incisor and put on the tooth paneling. I recently had an implant and I’m having second thoughts about it. My dentist applied a temporary glue that should stick my implant for about 2-3 years and I would have to visit him when it falls “if I find it” which isn’t convenient. I haven’t thought about the downsides of an implant as much since I was a kid. Anyway my question is can I remove the implant, put the braces on and close the gap? If yes can you explain roughly how long would that take with all the steps? And most importantly would you recommend me choosing this pathway regardless of how much it may cost? Thank you doctor
And by the way I’m 20 years old
Don’t remove the implant. If it falls off change the crown to a screw retained crown that will not be able to fall off! 😁
I just had dental implants year and have ago, when I was doing regular clean up and check up the hygienist told me on of the implant loss little bone but the rest is okey so do I have to worry or what is the remedy
You need to closely monitor this with exam and x-rays every six months to a year
You might need some touch up bone grafting or a gum graft to fill in any defect
Sometimes just keeping it clean with a WaterPik will keep it from advancing
As long as the implant is in the bone and there is reasonable gum on the outside of it it should last a very long time 😀
thank you DR Amin your kind advice, is it common dental implants to lose little bit of bone and how far of loss I should start worrying, if I keep up my check and cleaning routine regularly it helps or do I have to take other remedies.
Thank you
10% bone loss around an implant is normal. If it starts getting higher than 10%, then there is reason to worry. Cleaning implants is a bit different than teeth. Use a waterpick!
I had two implants in my lower jaw which contain for teeth in the very front. They were at a different angle than the originals and came in contact with my upper teeth which eventually causing some to crack and break. The dentist then installed 3 very expensive crowns which ultimately collided with my Lord teeth and broke and fell out what would you suggest my recourse for correcting. can the bottom teeth be taken out and unscrewed and repositioned at a different angle?
I would suggest that the upper and lower teeth be made at the same time. The balance of the bite is critical. Something seems really wrong here. You may want to seek out an expert who routinely restores complex implants. The front of the mouth is always consider the most difficult for so many reasons. The me know how it works out. Stay safe during COVID 19!