Failed dental implants or a failed bone graft: a second opinion on what can be fixed

Can a failing implant be saved?

Sometimes. It depends on whether the implant is still firm and how much bone is gone. A wobbling bridge is often a screw, not an implant, so first we sort out which problem you have:

Mechanical problems are common with full-arch bridges: a review of All-on-4 found mechanical complications in 5.91% and biological ones in 6.54%. In a long series from the clinic that developed the technique, they were far more frequent with the provisional bridge (58.8%) than with the definitive one (7.3%).

Your own dentist or a periodontist can treat much of this. We usually step in when implants must come out and too little bone is left for new conventional ones.

Why implants fail

Most implants last: in studies followed for 10 to 25 years, about 95% were still in place. In place is not the same as healthy, though: success measured with health criteria averaged 85.1%, and each study defined it differently. Early failures never bond to the bone; late ones lose bone after working well. The risk factors with the most evidence:

Rescue options when the bone is gone

Failed implants and grafts in the upper jaw often take bone with them. The 2023 ITI consensus lists failed grafts or implants among the main indications for zygomatic implants, which anchor in the cheekbone. The options depend on your CT:

These are major procedures with trade-offs. In studies with at least 5 years of follow-up, average survival was 96.5% for zygomatic and 95.8% for conventional implants, with no statistically significant difference. Sinusitis is the most commonly reported biological complication: 2.4% in one large review, 14.2% at 5 years in another. Pterygoid implants showed 97.9% survival in one review (low to very low certainty) and a higher risk of loss than conventional implants in another (95.25% versus 97.88% survival).

With some bone left, a 2026 review advises also weighing less invasive options: short or tilted implants, bone regeneration or a custom subperiosteal implant. The ITI consensus also notes that placing zygomatic implants during tooth extractions can increase risks; when failing implants come out is decided case by case.

What to send for a second opinion

1. 01

   Your CT scan, as DICOM files

   The full set from the imaging center, covering the upper jaw, sinuses and cheekbones; not screenshots or only the report. It is usually too large for a chat message: tell us you have it and we'll explain how to share it.

2. 02

   Earlier X-rays

   Older panoramic X-rays or scans show how the bone has changed.

3. 03

   Your implant records

   Brand and size of each implant, when they were placed, any grafts or sinus lifts, and surgical notes if you have copies.

4. 04

   Photos and a short timeline

   Front, side and bite photos, with and without your denture or bridge, and what has been done so far.

5. 05

   Your medical history

   Conditions, medications (especially bone medications and blood thinners), smoking, radiation and, if you have diabetes, your latest HbA1c.

How the review works

1. 01

   You send your records

   By WhatsApp or email, with a few lines about what is happening.

2. 02

   Dr. Torres reviews them

   He studies the bone, the sinuses and the failing implants on your CT, with your history.

3. 03

   A video consultation

   He explains what he sees, what may be saved and which options may fit, including care close to home.

4. 04

   An in-person evaluation, if it makes sense

   At our office in Tower 1 of Hospital CIMA, Escazú, each option is discussed with its risks, benefits, total time and long-term outcomes; the exact quote comes after the CT evaluation.

A remote review gives a provisional opinion. In-person appointments remain the standard of care, and the exam confirms or changes the plan.

Every surgery at our practice is led by Dr. Ronald Torres Labardini, an oral and maxillofacial surgeon certified by the Mexican Board of Oral and Maxillofacial Surgery. He completed his specialty at UNAM (Mexico) in 2013, has taught at the University of Costa Rica School of Dentistry since 2006, is an IAOMS member and has been with the AO Foundation since 2012.

He holds a 5.0 rating across 104 patient reviews on HuliHealth (2019–2026), about his oral and maxillofacial surgery in general, not implants. On April 6, 2025, a patient wrote: «Claridad en explicar el diagnostico y los eventuales escenarios para proceder con el tratamiento a seguir» (“Clarity in explaining the diagnosis and the possible scenarios for the treatment to follow”).