Dental implants are small, screw-shaped posts, often made of titanium, surgically placed into the jawbone to replace missing tooth roots. They support artificial teeth like crowns, bridges, or dentures, restoring chewing function and appearance. While dental implants are designed for exceptional longevity, situations can arise where their removal becomes necessary, even though they are considered a permanent tooth replacement solution.
Why Dental Implants Are Removed
Various complications can necessitate the removal of a dental implant, making it a response to an underlying problem rather than a routine procedure. One common reason is peri-implantitis, a bacterial infection causing inflammation and bone loss around the implant. Similar to gum disease, this condition can lead to the deterioration of the supporting bone, causing the implant to loosen if left untreated. Poor oral hygiene and plaque buildup are frequent contributors to peri-implantitis.
Poor osseointegration is another reason for implant removal, referring to the implant’s failure to properly fuse with the surrounding jawbone. This often occurs in the early stages after placement, typically within the first few months. Factors contributing to this failure can include infection at the surgical site, inadequate bone quality, or the body’s immune response to the implant material.
Nerve damage can also prompt implant removal, particularly if the implant is placed too deeply or too close to a major nerve, such as the inferior alveolar nerve in the lower jaw. Symptoms include persistent pain, numbness, or tingling sensations in the lips, chin, or tongue. Severe or persistent cases may require extraction to alleviate discomfort.
Mechanical issues, such as an implant fracture, can also lead to removal. Implants can break due to excessive forces from teeth grinding (bruxism), biting on hard objects, or improper bite alignment. Bone loss around the implant can also increase its susceptibility to fracture. An implant may also be removed if initially placed in an incorrect position, leading to functional problems with the bite or aesthetic concerns where the implant is visible or improperly aligned.
How Dental Implants Are Removed
The method for removing a dental implant depends on its integration with the jawbone and the reason for removal. Before any procedure, the dental professional conducts a thorough assessment using imaging techniques like X-rays or cone-beam computed tomography (CBCT) scans. This evaluates the implant’s condition and surrounding bone, aiding in planning the removal approach.
For implants that have not fully integrated or are loose, a non-surgical technique may be used. A specialized reverse torque device can often unscrew the implant from the jawbone with minimal invasiveness. This method is preferred as it causes less trauma to the surrounding bone and soft tissues. This technique involves engaging the implant with a tool that applies a controlled counter-rotational force, effectively reversing its insertion.
If the implant has successfully fused with the bone, a surgical approach is typically required. The procedure usually begins with local anesthesia to ensure patient comfort. A small incision is then made in the gum tissue to expose the implant and the bone around it. Specialized instruments are then employed to carefully detach the implant.
One common surgical tool is a trephine bur, a hollow, cylindrical drill with serrated edges. This bur is used to create a precise circular cut in the bone immediately surrounding the implant, effectively releasing its bond with the jawbone. The trephine is operated at a low speed with continuous irrigation to prevent overheating the bone. After the bone cut, the implant can often be gently removed using an explantation kit or specialized forceps. In some instances, piezosurgical units, which use ultrasonic vibrations, may be used for precise and conservative bone removal around the implant. The goal is always to remove the implant while preserving as much healthy bone as possible, especially if a new implant is being considered.
Life After Implant Removal
Following dental implant removal, post-operative care focuses on managing discomfort and promoting healing. Patients can expect some swelling, tenderness, and minor bleeding in the area, which are normal and typically subside within a few days. Pain medication, as prescribed by the dentist, and ice packs can help alleviate these symptoms.
Proper oral hygiene is important during healing. Gentle rinsing with an antimicrobial mouthwash or warm salt water may be recommended, while aggressive brushing near the surgical site should be avoided initially. A soft food diet is advised to prevent unnecessary strain on the healing area, and patients should avoid smoking and consuming alcohol, as these can impede the healing process.
Bone grafting is often a necessary step after implant removal, particularly if significant bone loss occurred around the failed implant or if a new implant is planned. This procedure helps to repair any defects in the jawbone by adding bone material, restoring its volume and density. This creates a more stable foundation for future tooth replacement options.
After the healing period, which can vary depending on the extent of the procedure and individual healing capabilities, several options are available for replacing the missing tooth. A new dental implant can often be placed in the same site once the bone has fully healed and been augmented, if necessary. Other alternatives include a traditional dental bridge, which uses adjacent teeth for support, or a removable partial denture. In some cases, depending on the patient’s preferences and oral health, the area may simply be left to heal without further tooth replacement. Regular follow-up appointments with the dental professional are important to monitor the healing progress and discuss the most suitable long-term solution.