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.
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