A dental implant is a titanium screw surgically placed into the jawbone, serving as a replacement for a missing tooth root. This fixture provides a stable, permanent anchor for an artificial tooth, or crown. Experiencing movement or looseness signals an underlying issue that requires immediate professional evaluation. Addressing a loose implant quickly is necessary to prevent further complications, as its stability is directly linked to the health of your jawbone and surrounding tissues. This guide clarifies the reasons for looseness and the steps involved in professional removal and subsequent restoration.
Common Reasons for Implant Loosening
Looseness does not always mean the titanium fixture itself has failed; sometimes, the issue is mechanical and less severe. The most frequent cause of perceived looseness is a problem with the crown or the abutment, the connector piece between the crown and the fixture. This mechanical failure occurs when the small screw holding the abutment has untightened, or if the cement holding the crown has worn down over time.
A more serious cause is biological failure, which can occur either early or late. If the implant never properly stabilized in the first few months after placement, it is likely due to failed osseointegration, meaning the titanium post did not successfully fuse with the jawbone. This can happen because of poor bone density, excessive pressure on the implant before healing was complete, or improper surgical placement.
The most common long-term biological failure is caused by peri-implantitis, an infection similar to gum disease that affects the tissue and bone surrounding the implant. This bacterial infection leads to the progressive loss of supporting jawbone, which eventually compromises the fixture’s stability. If the bone support deteriorates significantly, the implant will begin to move, indicating the need for intervention to prevent the infection from spreading.
What to Do Immediately
If you notice any movement in your implant, contact your dental professional immediately. A loose implant should be treated with urgency, even without pain, as early intervention improves the chances of a favorable outcome. When you call, describe the symptoms, including when the looseness began, and whether you are experiencing swelling, bleeding, or pain.
Until your appointment, avoid chewing or applying pressure to the affected side of your mouth. Do not attempt to fix or adjust the implant yourself, including trying to re-tighten the screw or using adhesive. Attempting a repair can cause severe damage to the implant threads, surrounding bone, or gum tissue, and can introduce bacteria leading to infection.
Delaying treatment risks the underlying problem worsening, especially if peri-implantitis is present. If the crown or abutment is completely detached, there is a risk of accidentally swallowing or aspirating the component. If the visible part comes off, clean it gently, store it safely, and bring it to your dental appointment for assessment.
The Professional Removal Process
The first step is a comprehensive diagnosis, typically involving a clinical examination, gentle probing, and imaging like X-rays or a CT scan. This assessment determines which component is loose and the extent of any bone loss around the fixture. The treatment path depends on whether the problem is mechanical or if the implant post itself is mobile.
If the looseness is confined to the crown or the abutment, the fix is often straightforward and does not require removing the titanium post from the bone. The dentist will remove the crown, access the abutment screw, and then tighten or replace the screw with specialized tools. The crown can then be re-cemented or reattached, resolving the perceived looseness quickly.
When the titanium fixture itself is loose, removal is necessary, indicating complete failure of the bone-to-implant connection. If the implant never properly integrated, removal is often minimally invasive, using specialized instruments to reverse the placement torque. If the cause is severe peri-implantitis, the procedure may be more involved, potentially requiring a small gum incision and specialized cutting instruments to free the implant from the surrounding bone.
Next Steps After Implant Removal
Once the failed implant is removed, the priority shifts to healing the extraction site and preparing the jawbone for future restoration. The soft tissue recovers quickly, but the underlying bone requires a longer healing period. The dental professional will thoroughly clean the area to eliminate any lingering infection or debris before closure.
Implant failure often results in a bone deficit, necessitating a bone grafting procedure. Bone grafting involves placing bone material (sourced from the patient, a donor, or synthetic materials) into the socket to rebuild the height and width of the jawbone. This step ensures there is adequate, stable bone volume to support a replacement implant successfully.
After the bone graft has fully integrated (which can take four to nine months depending on the graft size), the patient can explore replacement options. The most common option is placing a new dental implant once the site is fully healed and the bone volume is restored. Other possibilities include a traditional dental bridge, which uses the adjacent teeth for support, or a removable partial denture. Long-term maintenance, including diligent oral hygiene and regular dental checkups, is important to prevent future complications.