Direct answer

A failed or problematic titanium implant can sometimes be removed and later replaced with a zirconia implant, but it is not a direct material exchange. The team must identify why the implant or restoration failed, assess remaining bone and tissue, control infection or overload, remove the implant with minimal damage, and determine whether grafting and healing are needed before retreatment.

Key takeaways

  • A loose crown, abutment problem, or esthetic concern may not require implant removal.
  • Removal can enlarge the bone defect and change what replacement is possible.
  • Previously failed sites have lower pooled survival than first-attempt sites.
  • Zirconia should be chosen only if its system and dimensions suit the rebuilt site.

First identify what actually failed

The issue may involve the crown, cement, screw, abutment, implant position, fracture, failed integration, peri-implantitis, bone loss, recession, sensitivity concern, or patient preference. Repairing or replacing a restoration is different from removing an integrated implant. Symptoms attributed to material require careful differential diagnosis.

What does implant removal involve?

Removal technique depends on integration, fracture, position, and surrounding anatomy. Even conservative removal can sacrifice bone. The site may need debridement, infection control, grafting, soft-tissue reconstruction, and a healing interval. A temporary tooth must avoid damaging the site.

Why did the first implant fail?

Before retreatment, assess periodontal disease, plaque, smoking, diabetes control, implant position, bone, restoration cleanability, bite and bruxism, component failure, and maintenance. Some causes cannot be proven, but modifiable risks should be addressed rather than assuming a different material will solve them.

Choosing the replacement plan

Compare another implant, a bridge, removable option, site development, or no replacement. If zirconia is considered, confirm that available implant diameter, length, connection, restorative flexibility, and evidence fit the post-removal defect. Ask what happens if adequate stability cannot be achieved.

Selected references

  1. Gomes GH, et al. A systematic review and meta-analysis of the survival rate of implants placed in previously failed sites. Brazilian Oral Research. 2018;32:e27. doi:10.1590/1807-3107bor-2018.vol32.0027.
  2. Roehling S, Gahlert M, Bacevic M, Woelfler H, Laleman I. Clinical and radiographic outcomes of zirconia dental implants—a systematic review and meta-analysis. Clinical Oral Implants Research. 2023;34(Suppl 26):112–124. doi:10.1111/clr.14133.