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Home·Expertise·Peri-Implantitis
Implant Retreatment

Peri-Implantitis
& Implant Failure

Diagnosis and surgical management of peri-implant disease — including cases with combined hard and soft tissue deficiencies, failed implants, and suboptimal prosthetic designs that are driving ongoing inflammation.

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Retreatment scope
DiagnosisFull workup
ApproachSurgical
Bone defectsRegenerative
ReferralsWelcome
The Protocol

Diagnosis first.
Surgery with a plan.

Peri-implantitis cannot be managed without understanding its cause. The retreatment protocol begins with comprehensive diagnosis — before any surgical commitment — to establish whether the implant is salvageable and what intervention is required.

01
Diagnosis
CBCT, probing, radiographic assessment, prosthetic evaluation

Full periodontal charting around all implants. CBCT analysis of bone defect morphology, implant position, and proximity to anatomical structures. Assessment of the prosthetic design for factors driving peri-implantitis — cement residue, emergence profile, occlusal overload.

02
Non-Surgical Phase
Implant surface decontamination · Cause elimination

In cases amenable to non-surgical management, a structured decontamination protocol is initiated — including subgingival instrumentation, implant surface treatment, and prosthetic modification where indicated. Non-surgical treatment is a prerequisite before any surgical phase.

03
Surgical Intervention
Resective or regenerative approach based on defect morphology

For cases not responding to non-surgical management, or where bone defect morphology indicates surgical access: open-flap debridement with implant surface decontamination. For contained intrabony defects, regenerative approaches with bone grafting and barrier membranes. For shallow, irregular defects, resective surgery with implantoplasty.

04
Tissue Reconstruction
Soft tissue augmentation · Re-establishing the biological seal

Where peri-implant mucosal recession or tissue deficiency is present, connective tissue grafting or free gingival grafts are incorporated into the surgical session — rebuilding the biological width and re-establishing the mucosal seal that prevents further disease progression.

05
Maintenance Protocol
Structured follow-up · Cause control

Peri-implantitis recurs in the absence of structured maintenance. A post-surgical protocol is established — with clear intervals, monitoring parameters, and criteria for re-intervention — in collaboration with the patient's regular dental team.

Complex Cases

When the implant
cannot be saved

Not every peri-implantitis case is salvageable. When bone loss is extensive, implant position is prosthetically untenable, or the implant surface is too compromised for predictable decontamination, explantation followed by site regeneration and re-implantation is the more responsible treatment path.

These cases require careful sequencing: explantation, socket regeneration, healing period, re-assessment, and re-implantation with a corrected prosthetic plan. The same digital workflow used for primary implant placement is applied to the retreatment — ensuring the second implant is positioned where the biology and the prosthetic outcome require it.

Patients referred after inadequate initial treatment elsewhere are a significant part of this practice. The assessment begins without prejudice — the clinical record is reviewed, the cause of failure is identified, and a realistic treatment plan is proposed.

Second Opinion

If you have been told your implant is failing or needs to be removed, a second opinion from a specialist in peri-implant disease is warranted before committing to further treatment. Send your existing radiographs and clinical notes for a remote preliminary assessment.

Risk factors for peri-implantitis that are frequently undermanaged include: history of periodontitis, smoking, inadequate keratinised tissue around the implant, subgingival cement, and implant positions that make effective hygiene impossible. Treatment without addressing these factors will not prevent recurrence.

FAQ

Common questions

How do I know if I have peri-implantitis?
The classic signs are bleeding on probing around the implant, suppuration, increasing pocket depth at implant sites, and radiographic evidence of bone loss around the implant. Mucosal recession and implant mobility are later signs. If you notice any of these, early assessment gives the best options for management.
Can peri-implantitis be treated non-surgically?
In early-stage peri-implantitis with minimal bone loss, non-surgical management — implant surface decontamination, cause elimination, and structured maintenance — can stabilise the condition. For moderate to advanced cases with bone defects, surgical intervention is required for predictable outcomes.
My implant was placed by another dentist — can you still treat it?
Yes. A significant proportion of retreatment cases come from patients referred by other practitioners or who seek a second opinion after a peri-implantitis diagnosis elsewhere. The assessment is based on the current clinical and radiographic picture — the history of who placed the implant is not a barrier to treatment.
Will I need a new implant if the current one fails?
If the implant cannot be saved, the site is regenerated after explantation and a new implant is placed in a planned, digitally guided procedure. Outcomes for re-implantation in regenerated sites are generally good when the cause of the original failure has been identified and corrected.
Related Procedures

Often combined

GBR
Guided Bone Regeneration

Bone regeneration is frequently part of the peri-implantitis surgical protocol — for contained defects amenable to a regenerative approach.

 Soft Tissue
Mucogingival Surgery

Soft tissue reconstruction is incorporated where peri-implant mucosal recession or deficiency is part of the retreatment picture.

 Re-implantation
Guided Implant Surgery

When re-implantation is indicated after explantation, the same digital workflow ensures the second implant is positioned correctly from the start.

Early assessment gives
the most options.

Peri-implantitis is most manageable in its early stages. Send existing radiographs and clinical notes for a preliminary remote assessment before booking an appointment.

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