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Dental implants are one of the most advanced and successful solutions in restorative dentistry. When placed properly and maintained with good hygiene, a dental implant can last 20 years or more. In fact, multiple long-term studies confirm that implants have a success rate of over 95% in healthy patients 1. But like any medical or dental procedure, complications can occur—and when they do, patients often want to know: what happens if a dental implant fails?
At Montana Center for Implants and Dentures, we’ve restored hundreds of smiles using dental implants, and we’re equally experienced in identifying and treating implant complications. Whether you’re considering implants or already have one that’s giving you trouble, this article explains the signs of failure, causes, and corrective options so you can make informed decisions about your oral surgery and long-term care.
Understanding Dental Implant Failure
Dental implant failure refers to the inability of the implant to properly integrate with the jawbone (osseointegration) or to remain stable over time. Failure can be classified into two main types:
- Early failure: Occurs within the first few months after implant placement, usually before the final crown or prosthesis is attached.
- Late failure: Occurs after osseointegration is complete, often months or years after the implant has been restored.
While failure is relatively rare, data from a systematic review in the Journal of Dental Research suggests that up to 5–10% of implants may fail depending on risk factors such as smoking, uncontrolled diabetes, or poor oral hygiene 2.
What Causes a Dental Implant to Fail?
1. Poor Osseointegration
Successful dental implants rely on the process of osseointegration, where the bone fuses with the implant surface. Factors that interfere with this process include:
- Inadequate bone quality or volume
- Overheating of bone during drilling
- Immediate loading without sufficient support
- Patient-related issues such as smoking or bruxism (teeth grinding)
A 2018 study in Clinical Implant Dentistry and Related Research found that poor primary stability at the time of placement was the most common predictor of early failure 3.
2. Peri-Implantitis
This is an infection of the gum and bone surrounding the implant. It is similar to periodontitis (gum disease) and can result in:
- Bone loss
- Gum recession
- Implant loosening
According to The International Journal of Oral & Maxillofacial Implants, up to 20% of implants may develop peri-implantitis, particularly in patients with a history of periodontal disease or poor plaque control 4.
3. Mechanical Complications
Even if integration is successful, mechanical issues can arise:
- Fracture of the implant or abutment
- Loosening of screws
- Prosthetic component failure (e.g., cracked crown)
Improper load distribution or poor bite alignment are often contributing factors.
4. Systemic Health Conditions
Certain health issues can interfere with healing and bone maintenance:
- Uncontrolled diabetes
- Autoimmune diseases
- Osteoporosis (particularly when combined with bisphosphonate use)
A comprehensive evaluation at Montana Center for Implants and Dentures helps identify these risk factors before oral surgery is performed.
5. Smoking
Cigarette smoke impairs circulation and reduces the body’s ability to fight infection and regenerate bone. A meta-analysis in Clinical Oral Implants Research concluded that implant failure in smokers is nearly twice as likely compared to non-smokers 5.
Signs That a Dental Implant May Be Failing
Recognizing the early signs of implant failure is key to preventing long-term complications. Patients should contact their provider if they notice:
- Persistent pain or swelling beyond the normal post-op healing phase
- Implant mobility (even slight movement is a concern)
- Recession or discoloration of the gum around the implant
- Pus or bleeding at the gum line
- Changes in bite or difficulty chewing
- Exposed implant threads or gaps between the implant and the crown
At Montana Center for Implants and Dentures, we use 3D imaging and digital probing to assess implant stability and soft tissue health during routine checkups.
What Happens If a Dental Implant Fails?
The next steps depend on the timing and cause of the failure.
Early Failure: Implant Never Integrates
If the implant does not integrate with the bone, it will usually become loose or painful within the first three months. In this case:
- The implant is removed
- The site is allowed to heal for several weeks to months
- In some cases, bone grafting may be required to restore lost volume
- A new implant may be placed later, using a modified approach
Late Failure: After Restoration Is Complete
If the implant fails months or years after loading, the treatment plan may be more complex:
- The implant is removed
- The surrounding bone is assessed for damage or infection
- Debridement and grafting are done if bone loss is present
- After healing, a new implant or alternate restoration (like a bridge) is considered
Late failures often require more extensive intervention, but with proper care, most patients still qualify for a second attempt.
Can a Failed Implant Be Replaced?
In many cases, yes. A failed implant can often be replaced successfully, especially if the underlying cause is identified and addressed. Studies show that re-implantation has a success rate of 85–90%, though it may require additional procedures like sinus lifts or bone grafts 6.
At Montana Center for Implants and Dentures, our team performs full diagnostic evaluations before considering reimplantation. This includes CBCT imaging, microbiological testing (in peri-implantitis cases), and medical history screening.
Preventing Implant Failure: What You Can Do
The best way to handle implant failure is to prevent it in the first place. Here are the most effective strategies for protecting your investment:
1. Maintain Excellent Oral Hygiene
Brush twice a day with a soft-bristled toothbrush, use interdental brushes or floss, and rinse with an antimicrobial mouthwash. Studies confirm that daily plaque control reduces the risk of peri-implant inflammation by up to 70% 7.
2. Quit Smoking
Smokers are at a significantly higher risk of both implant failure and post-op complications. Quitting even temporarily during the healing phase can improve outcomes.
3. Attend Regular Maintenance Appointments
Professional cleanings every 3–6 months help detect early signs of infection or mechanical issues. Your provider will also check the integrity of the prosthetic components and bone levels.
4. Follow Post-Surgical Instructions
After oral surgery, avoid chewing on the implant site, refrain from vigorous rinsing or spitting, and take all prescribed antibiotics or anti-inflammatories. Healing typically takes 3–6 months.
5. Consider a Night Guard
Patients who grind or clench their teeth (bruxism) may place excessive force on their implants. A night guard can protect both the implant and the restoration.
Smile Makeover Planning After Implant Failure
For patients who experience implant failure but want to continue with a smile makeover, multiple solutions are available:
- New implant placement with supportive bone grafting
- Implant-supported bridge using neighboring healthy implants
- Implant-retained dentures (fewer implants supporting a full arch)
- Fixed or removable prosthetics as temporary or permanent alternatives
Our team at Montana Center for Implants and Dentures helps patients reevaluate their smile goals and design a plan that reflects both health status and cosmetic expectations.
Final Thoughts
While dental implants are one of the most successful forms of oral surgery, complications do happen. Understanding what happens if a dental implant fails empowers patients to act quickly, preserve their bone and soft tissue health, and move forward with a new strategy when needed.
The key takeaway is that failure doesn’t mean the end of your smile restoration journey. With advances in diagnostics, biomaterials, and surgical techniques, most failed implants can be addressed and even replaced with excellent outcomes.
At Montana Center for Implants and Dentures, Dr. Josh Muir and Dr. Tanner Townsend offer full-spectrum care—from initial implant placement to management of complications and complete smile makeovers. Whether you’re evaluating an implant for the first time or troubleshooting an issue with an existing one, we’re here to help you restore health, function, and confidence.
Footnotes
- Pjetursson, B.E., et al. “A systematic review of the survival and complication rates of implant-supported fixed dental prostheses.” Clinical Oral Implants Research, 2007. ↩
- Chrcanovic, B.R., et al. “Factors influencing dental implant failure.” Journal of Dental Research, 2016. ↩
- Derks, J., et al. “Effectiveness of implant therapy analyzed in a Swedish population.” Clinical Implant Dentistry and Related Research, 2018. ↩
- Zitzmann, N.U., Berglundh, T. “Definition and prevalence of peri-implant diseases.” International Journal of Oral & Maxillofacial Implants, 2008. ↩
- Hinode, D., et al. “Influence of smoking on osseointegrated implant failure: a meta-analysis.” Clinical Oral Implants Research, 2006. ↩
- Levin, L., et al. “Retreatment outcomes of failed dental implants.” International Journal of Oral and Maxillofacial Surgery, 2015. ↩
- Heitz-Mayfield, L.J.A., et al. “Maintenance of implants: an evidence-based review.” Journal of Clinical Periodontology, 2010. ↩
