What does it mean for an implant to “fail”?
An implant fails when it does not bond with the jawbone, or when that bond is lost later. In both cases the implant can become loose, no longer carries the chewing load and usually has to be removed.
A systematic review in the International Journal of Environmental Research and Public Health (Do et al., 2020) distinguishes two forms. Early failure happens before the implant is loaded with a tooth: the bond with the bone never forms. Late failure happens after loading, when an existing bond is destroyed. Leeds Teaching Hospitals NHS Trust describes it as rare for an implant never to knit to the bone, and lists smoking, poorly controlled diabetes, poor oral hygiene, a history of gum disease, medicines such as bisphosphonates and radiotherapy to the jaws as factors that raise the chance of late failure.
How do early and late failure differ?
| Feature | Early failure | Late failure |
|---|---|---|
| When? | During healing, before the final teeth | After loading, sometimes only after years |
| What happens? | The implant does not bond with the bone | An existing bond is lost |
| Main causes | Biological factors that prevent bonding | Mostly inflammation around the implant; less often overload or fracture |
| Common signs | Mobility, persistent pain, inflammation | Bleeding gums, swelling, pus, eventually mobility |
The figures depend on what is studied. In a retrospective study of 9,080 implants (Staedt et al., 2020), 96.13% remained in place over the observation period; of the 351 implants lost, 83.5% were lost in the first six months, that is, early.
Halstenbach and colleagues (2026), by contrast, analysed 738 implants removed at one centre between 2014 and 2024: 14.5% early and 85.5% late. Late-removed implants with a known placement date had been in function for an average of 7.4 years, and inflammation played a part in 71% of late failures. Because only removed implants were studied, the paper says nothing about what share of all implants is lost.
Why does an implant fail to integrate?
Early failure often cannot be traced to a single cause; Do and colleagues describe it as a purely biological problem. In a study in BMC Oral Health (Krisam et al., 2019), 9 of 186 implants (4.8%) placed in a practice specialising in implantology were lost before the teeth were fitted; implants shorter than 10 mm and grafted sites carried a higher risk.
In late failure, inflammation is the main factor. Do and colleagues group the risk factors as follows:
- History: radiotherapy to the jaw, tooth grinding, gum disease and a previous early failure
- Site: soft bone of low density and the back regions of the jaws
- Treatment: for example, low stability of the implant at placement
See our guides Smoking and dental implants, Dental implants with diabetes and peri-implantitis.
How do you recognise a failing implant once you are home?
The clearest sign is a loose implant. Staedt and colleagues defined early failure by marked mobility, pain or a radiolucent line around the implant on an X-ray. Cleveland Clinic lists these reasons to contact your dentist:
- a loose or wobbly implant
- swollen or bleeding gums around the implant
- pus at the implant
- a fever
Swelling and tenderness in the first days are to be expected; pain that increases instead of fading, or pus that starts after some days, should be reported. Most of the healing period falls after your flight home. If you notice these signs, send us photos and a short description on WhatsApp; with severe pain, fever or swelling, a dentist or emergency dental service near you is the first place to go. Not every loose part is the implant itself; the tooth or the screw on top of it can also have come loose.
What is done when an implant has not integrated?
The approach is individual, but usually follows these steps:
- Examination and imaging: whether the implant really has failed, how much bone has been lost and what the cause might be.
- Removing the implant: usually under local anaesthetic; inflamed tissue is cleaned away.
- Healing: the site heals. In a visible area, a temporary solution is discussed.
- Bone grafting if needed: with greater bone loss, bone grafting may be needed before or together with the new implant.
- A new implant or another solution: as Leeds Teaching Hospitals describes, after an early failure your dentist also discusses alternatives such as a bridge or a removable denture.
There is no fixed rule for the waiting time. In the systematic review by Gomes and colleagues, the interval between removal and re-implantation ranged from the same appointment to several years, and in one study cited there, immediate and later replacements did not differ significantly. For travellers, a failure usually means an additional trip, timed according to healing.
How well does a second implant integrate?
Most replacement implants integrate, but at lower rates than a first implant. The 2018 review in Brazilian Oral Research (Gomes et al.) pooled 11 studies:
| Situation | Share of implants that remained in place |
|---|---|
| Second implant after one failure | 88.7% |
| Third implant after two failures | 67.1% |
| New implant after an early failure | 91.8% |
The review by Oh and colleagues (2019) of eight retrospective studies found 86.3% for replacement implants, and 93 to 96% in more recent studies. A commentary on this review notes that in one cited study only about 23% of failed sites were suitable for a new implant. Gomes and colleagues name poor bone quality and quantity as factors in the loss of a replacement implant, which is why the cause of the first failure needs to be understood before the second implant is placed.
What does this mean for treatment in Türkiye?
The General Dental Council advises asking before you commit who pays for extra flights, accommodation and remedial work, whether the work is guaranteed for a set period and who you can contact afterwards. It also recommends telling your own dentist about your plans, so that they are aware in case of later complications. The NHS treatment abroad checklist adds that you should be clear about how your aftercare will be coordinated and should stay in the country of treatment long enough to recover.
At Rönesans, problems not caused by the patient are covered by a warranty with defined conditions, explained at the examination before treatment starts. If a correction covered by the warranty requires a return visit, we cover your travel costs. Our guide How to choose a dental clinic in Türkiye lists further questions to ask, and our page on aftercare and follow-up describes what happens after you return.
How can you lower the risk of failure?
- If you smoke, discuss stopping, or at least a break, before you travel.
- If you have diabetes, keep your blood sugar under control and send us recent results.
- Tell us about all your medicines and conditions; do not stop any medicine on your own.
- Follow the advice on eating, oral hygiene and temporary teeth during healing.
- Clean the implant every day and keep check-ups with your dentist at home.
- Report tooth grinding or clenching, and report mobility, pus or increasing pain at once, also between trips.
What do we do at Rönesans if an implant fails?
First, with an examination and a cone-beam CT (CBCT) scan at our clinic in Serdivan, we establish whether the problem lies with the implant or with the parts on top of it, and how much bone has been lost. Your implant card helps us to identify the exact implant. If bone grafting is needed before a new implant, we carry it out at our clinic; treatment under general anaesthetic is possible if required. Our dentists work out the new plan together, and your treating dentist remains the same person.
Between your trips you can reach us on WhatsApp at +90 532 363 49 54 or by phone on +90 264 606 09 43; during opening hours we reply in English and German within 15 minutes. The treatment steps are described on our dental implants page.