Key guidance to read first

Implant re-surgery · re-treatment at a glance

What is this treatment?
If an installed implant is loose or the surrounding gums are inflamed, we re-diagnose the cause first. The first step is to determine whether to try to save it, remove it, or replace only the components.
What concerns are addressed?
My implant is loose. There is bleeding or pus around the implant.
What precautions are there?
Postoperative pain, swelling, bleeding, infection, sensory changes, and failure of osseointegration may occur. Bone grafting or sinus surgery carries risks such as graft exposure or mucosal perforation, and varies by individual condition.

Related clinician: Director Kang Do-wook · Periodontics · Integrated Dental Medicine specialist

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BEFORE YOUR VISIT

Preparing for an implant revision consultation

A few things to consider before booking.

Tell us during your consultation

  • When you had previous treatment and your main current symptoms
  • When the discomfort started and how it has changed
  • Any guidance you have already received from another clinic

Helpful items to prepare

  • Previous treatment records, images and restoration information, if available
  • A list of your current medications

Questions to ask

  • What assessments are needed to determine whether the existing implant can be retained?
  • How do the possible treatments differ, what are their limitations, and what visits might be needed?
Contact the clinic

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The Good Morning Dental Clinic 02-969-3776

Read the related guidance
01 / YOUR CONCERNS

Do you have these concerns?

My implant is loose.
There is bleeding or pus around the implant.
Food catches too often around the implant.
Gums have receded and metal screws are visible.
Implant surrounding gum frequently swells and bleeds.
There is bad smell from the gum around the implant.
Adjacent teeth have begun to become loose.
Pain persists
The implant prosthesis (crown) is broken.
The prosthesis keeps falling out.
I was told the implant screw is broken.
I was told there is a crack in the implant body (fixture).
I hear clicking when chewing or feel looseness.
02 / UNDERSTAND YOUR CARE

What are implant re-surgery and re-treatment?

If an installed implant is loose or the surrounding gums are inflamed, we re-diagnose the cause first. The first step is to determine whether to try to save it, remove it, or replace only the components.

Re-surgery and re-treatment are different

Re-surgery removes and re-places an implant when preservation is difficult. Re-treatment replaces the prosthesis, screw, or abutment while keeping the fixture in place if only those parts are damaged. We do not decide removal based on looseness alone.

When gums are the problem — peri-implantitis

Peri-implantitis is inflammation of the tissues and bone supporting the implant. Early signs are swelling, bleeding, and odor, but it can progress to supporting bone loss. Lack of pain does not mean it is harmless. We assess inflammation extent and remaining bone to decide cleaning, infection control, regenerative treatment, or removal.

We divide damaged or broken parts

Crown fracture is remaking the prosthesis, screw fracture requires removal of the broken screw and replacement, and abutment damage may need abutment replacement. Availability of parts and fixture damage must be checked.

If the implant body (fixture) is fractured it may need removal and re-implantation. If causes include bone loss, bruxism, or occlusal imbalance, replacing parts alone may lead to recurrence.

Before re-implantation, identify the cause of failure

Determining the cause of fracture comes first. If bruxism, occlusal imbalance, or alveolar bone loss are causes, the same issues can recur. We also assess difficult-to-manage structures and insufficient keratinized gingiva. We do not finish treatment by re-implanting without addressing the cause.

Limits and precautions to know

Postoperative pain, swelling, bleeding, infection, sensory changes, and failure of osseointegration may occur. Bone grafting or sinus surgery carries risks such as graft exposure or mucosal perforation, and varies by individual condition.

03 / THE GOOD MORNING WAY

How The Good Morning provides care

  1. A periodontist re-diagnoses the cause first.
  2. If salvageable we preserve; if not, we consider bone reconstruction and re-implantation.
  3. Check if prosthesis or screw fractures can be replaced alone.
  4. We also treat implants placed at other clinics.
04 / STEP BY STEP

From diagnosis to aftercare: the treatment course.

  1. 01Diagnose bone defects, inflammation, and fracture sites
  2. 02Decide between preservation, removal, or part replacement
  3. 03Infection control, bone reconstruction, re-implantation, or part replacement
  4. 04After healing, prosthetic work and regular maintenance

Actual sequence and number of visits are adjusted according to test results and recovery.

Consultation tailored to your condition
05 / YOUR QUESTIONS · 24 QUESTIONS

Questions you might have before care.

01Does the implant have to be removed?
Not necessarily. Depending on the inflammation, cleaning around the implant and regenerating lost bone may allow the existing implant to be retained. A detailed examination to assess whether it can be saved comes first.
02Can you replant right on the day the implant was removed?
Depends on inflammation extent, remaining bone and primary stability. Immediate placement possible in some cases but may require infection control or bone reconstruction first.
03Can reoperation last long as well?
Identifying and addressing failure causes is important. Reimplanting without correcting causes may repeat problems. Reoperation also carries complication and failure risk and lifespan is not guaranteed.
04Do you evaluate implants done at other clinics?
Yes. Many come for peri-implantitis, fractures, or gum problems on implants placed elsewhere. Bring records or x-rays if available.
05What happens if an implant is loose and you leave it alone?
It is different when a prosthetic screw is loose versus when the support of the implant body is weakened. If there is inflammation or bone loss, leaving it untreated may increase the scope of treatment, so first identify the cause.
06What are symptoms of peri-implantitis?
Typical signs are swollen, red gums, bleeding when brushing, or pus when pressing around the implant. Early stages often have little pain and go unnoticed.
07If implant bleeds or has pus, must it be reoperated?
Likely inflammation of the implant surrounding gum and bone (peri-implantitis). If in the upper jaw, check for fistula to the sinus or sinusitis too.
08The gum around the implant has receded and the screw is exposed.
Check for causes like gum recession or bone loss. Evaluate whether bone regeneration or gum graft can improve it, but not all cases can be re-covered.
09Can implants break?
Possible. Fixtures or prostheses can fracture depending on maintenance, surrounding bone, and bruxism. Regular checks post-implantation are important.
10Is reoperation more expensive than the first time?
If removal, bone regeneration and reimplantation are needed, item count may increase and cost may be higher. If existing implant can be preserved costs are lower. Provide written estimate after CT diagnosis.
11How long does reoperation take?
If bone reconstruction is required, months may be needed for graft maturation. If removal and immediate placement are possible, the period shortens significantly.
12Can you know why it failed?
CT to check bone defect and implant stability can narrow causes in most cases. Explain causes such as peri-implantitis, bone deficiency, implant position, prosthetic mismatch, and bruxism.
13Is it because the implant's lifespan ended?
Rather than treating it like a part with fixed lifespan, assess jawbone, prosthesis and component status. First check preservation possibility and necessary treatments.
14Can’t you just redo the implant prosthesis?
If only the prosthesis is broken or loose, consider prosthesis repair · replacement. You must check the implant body · connecting components and the alveolar bone as well, and if you do not resolve the cause the same problem may recur.
15Was the implant brand the problem?
Do not attribute the cause to a single brand. Check multiple factors such as placement position · direction · components, condition of the alveolar bone, and occlusion · bruxism.
16Is reoperation possible under sedation?
Conscious sedation may help but is not suitable for everyone. Decide after evaluating systemic condition, medications, airway risk and treatment scope; refer to higher-level institutions if needed.
17How to prevent repeated failure after reoperation?
Three most important are quitting smoking, gum care, and regular checkups every 3–6 months. If bruxism exists, recommend night guard.
18Gum receded and screw is visible — can it be covered again?
Assess exposure causes, remaining bone and inflammation, consider bone regeneration and gum graft. Complete coverage may be difficult and removal may be necessary in some cases.
19There's an odor around the implant.
Often bacteria accumulate between implant and gum causing inflammation. Left untreated bone may resorb so early check is advised.
20Implant crown broke — do I need to re-implant?
If only prosthesis broke, check whether the main body can be retained and only the prosthesis remade. Verify if the fixture and connection parts are undamaged and investigate cause of breakage.
21An implant screw fractured — what to do?
Remove broken screw and replace with a new one. If implant fixture is intact removal is unnecessary. Repeated screw fractures may indicate occlusion or bruxism as cause and should be checked.
22Can implant fixture itself break?
Rare but possible. Severe bruxism or surrounding bone loss reducing support can crack the fixture. This may require removal and reimplantation.
23Prosthesis keeps coming off — why?
Possible causes: weak bonding area, loose screw, or occlusion concentrating force on a spot. Identify cause before reattaching to prevent recurrence.
24Is it a problem if there isn’t firm gum around the implant?
Lack of keratinized gingiva makes brushing difficult and inflammation likely. If needed keratinized tissue grafting can create maintainable gum.

Explore this treatment further

Treatment questions: 24Director’s explanatory videos
Implant

Also see related treatments

Advanced bone grafting +Sinus lift · sinus inflammation treatment +Gum line · gum grafting +Periodontitis +Bruxism · clenching +Sedation implants +Dental terms glossary +
Treatment case publication guidance

This information is for general understanding and does not replace clinician diagnosis. Treatment methods, durations, effects, and side effects vary by individual and require sufficient consultation before care.