Abstract
ObjectivesThis narrative review is aiming on showing reasons for implant failure, removal techniques, and respective clinical considerations; further, the survival rate of implants in previous failed sites is examined.Materials and methodsQuestions have been formulated, answered, and discussed through a literature search including studies assessing implant failure and removal up to 2018.ResultsStudies describing reasons for implant failure, implant removal techniques, and the reinsertion of implants in a previous failed site (n = 12) were included. To date, peri‐implantitis is the main reason for late implant failure (81.9%). Trephine burs seem to be the best‐known method for implant removal. Nevertheless, the counter‐torque‐ratchet‐technique, because of the low invasiveness, should be the first choice for the clinician. Regarding zirconia implant removal, only scarce data are available. Implantation in previously failed sites irrespective of an early or late failure results in 71% to 100% survival over 5 years.ConclusionIf removal is required, interventions should be based on considerations regarding minimally invasive access and management as well as predictable healing. (Post)Operative considerations should primarily depend on the defect type and the consecutive implantation plans.
Highlights
Periodontitis and dental caries are the main causes for tooth loss
Funding information Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich. This narrative review is aiming on showing reasons for implant failure, removal techniques, and respective clinical considerations; further, the survival rate of implants in previous failed sites is examined
Peri-implantitis is the main reason for late implant failure (81.9%)
Summary
Periodontitis and dental caries are the main causes for tooth loss. The prevalence of (partially) edentulous patients worldwide varies between 7% and 69% (Petersen, Bourgeois, Bratthall, & Ogawa, 2005). Implant failures can be described as early or late events in terms of time-point characterization These definitions are mainly based on initial healing and restorative stages. Implant failures can have multiple causes, that is, overheating of the bone during preparation of the implant site, lack of primary stability due to overpreparation of the implant site or poor bone quality, overload, or parafunctions (Froum et al, 2011) In this context, implants are clinically mobile and easy to remove. The attempt to remove the implants can still be very challenging, and the explantation may be invasive, and neighbor teeth and structures can be potentially harmed (Froum et al, 2011).Not surprisingly different methods of implant removal have been described in the literature so far including the use of counter-torque ratchet (2016), piezo surgery (2002), high-speed burs, elevators, forceps, trephine burs (2018) (2016)and laser surgery (2016). Clinically relevant questions were formulated, answered and discussed based on the available literature
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