Can My Failed Implant Be Salvaged? Bone Loss Around the Implant

When bone loss surrounds a dental implant on multiple surfaces, the situation is serious, and in some cases the implant can still be treated rather than removed. This is the defect pattern we classify as Case Type II: the implant is losing support around its circumference, and the defect tends to enlarge as bacteria colonize the deepening pocket unless the infection is controlled. The repair is more involved than for a single-wall defect. When the implant is still integrated and the defect can be cleaned and grafted, the implant and sometimes the existing crown can be retained. The case below documents one such outcome.

This article covers the encircling-defect scenario specifically. For the broader decision framework, start with our overview of whether a failing implant can be saved or repaired.

A Real Repair, Start to Six-Year Finish

One of our patients presented with a failing implant showing several millimeters of bone loss around it (Fig. 1). The plan followed our standard salvage discipline.

The abutment and crown were removed and carefully stored; they were well made and deserved to survive the repair. The implant surface was then detoxified, stripping away the bacterial biofilm that caused and sustained the bone destruction. With a clean surface to build against, the defect was grafted with growth-factor-enhanced bone (Fig. 2).

After four months the graft had matured, and the original abutment and crown were reseated on the same implant (Figs. 3 and 4). Six years later, the bone around the implant remains intact (Fig. 5).

Fig. 1: Failing Implant with Bone Loss Around It

Fig. 2: Bone Graft Repair Complete Fig. 3: Four Months Later, Bone Is Healed Fig. 4: Abutment and Crown Reseated After Healing Fig. 5: Six Years Later, Bone Is Intact

The six-year image documents this patient’s result. Whether another implant can be retained depends on its stability, defect, surrounding tissues and the restoration it supports. An evaluation should compare salvage, replacement and alternatives without promising that the same procedure will work in every case. Read who should evaluate a failing implant and our repairing failing implants service for the broader decision process.

Why This Repair Works, and When It Does Not

Three factors decide whether an encircled implant can be rescued. The implant itself must still be rigidly anchored; a mobile implant has already lost the battle. The defect must be cleanable and containable, so the graft has walls to build against. And the restoration above must be sound or rebuildable, since a poorly contoured crown will simply recreate the disease that caused the loss.

That last point matters more than patients expect. Bone loss around an implant is usually the end of a chain that began with bacteria finding a place to live. Repairing the bone without correcting the cause is renovation without fixing the leak. This is also what separates the encircling defect from its cousins: bone loss confined to the outside surface is a simpler, more contained repair, while bone destroyed by improperly performed implant surgery often requires rebuilding the site and placing a new implant correctly.

The Earlier the Evaluation, the More We Can Save

Bone loss driven by infection around an implant rarely improves without treatment, and the smaller the defect when it is addressed, the more options remain. If your implant shows bleeding gums, deepening pockets, or bone shadows on an X-ray, have it measured now. Dr. Gerald Marlin, a specialty-trained prosthodontist with more than 3,900 dental implants placed, will assess whether your implant, and even your existing crown, can be saved. Call 202-244-2101 or book a consultation at Elite Prosthetic Dentistry in Friendship Heights, Washington, DC.