Management of Failed Dental Implants: A Contemporary Review

AbstractDental implants have become the gold standard for the replacement of missing teeth due to their high success rates and predictable long-term outcomes. Despite advances in implant design, surgical techniques, and prosthetic rehabilitation, implant failures continue to occur and remain a significant clinical challenge. Implant failure may be classified as early or late depending on the stage of occurrence and may result from biological, mechanical, surgical, prosthetic, or patient related factors. Biological causes include failure of osseointegration, peri-implant mucositis, peri-implantitis, and systemic conditions that impair healing. Mechanical complications such as screw loosening, implant fracture, prosthetic component failure, and occlusal overload can also compromise implant survival. Accurate diagnosis through clinical and radiographic examination is essential for identifying the etiology of failure and planning right intervention. Management strategies range from non-surgical debridement and antimicrobial therapy to regenerative surgery, implant removal, and replacement. Recent developments in digital treatment planning, implant surface modification, regenerative biomaterials, and nanotechnology have improved the predictability of retreatment procedures. This review discusses the classification, causes, diagnosis, prevention, and management of failed dental implants while highlighting contemporary approaches that can improve long-term implant success and patient satisfaction.