Failed Dental Implant Repair
in Honolulu, HI
 Failed dental implant repair in Honolulu, HI is the diagnosis and surgical correction of a dental implant that has become loose, painful, or infected, or that never fully bonded with the bone.
At Pacific Maxillofacial Center, our board-certified oral and maxillofacial surgeons evaluate the failing implant, determine whether it can be saved or needs to come out, and plan the path back to a stable replacement.
If your implant was placed somewhere else, or by us, and something now feels wrong, you are in the right place. Implant revision is its own procedure, different from a first-time placement, and it is exactly the sort of case that general dentists across Honolulu and West Oahu refer to an oral surgery practice like ours. Implant failure is uncommon, and most dental implants last for decades, but when one does fail, it needs a specialist to sort out why and what comes next.
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Why Dental Implants Fail
 An implant fails when it loses its bond with the bone or the surrounding tissue breaks down. The most common cause is peri-implantitis, an infection of the gum and bone around the implant that, untreated, eats away at the support holding it. Other causes include osseointegration failure, where the implant never fully fused with the bone in the first place; mechanical problems like a loose or fractured abutment; excessive bite force; and risk factors such as smoking or uncontrolled diabetes that slow healing. Implant failure is not always anyone's fault. Sometimes the biology simply doesn't cooperate.
The warning signs are worth knowing. Pain around an implant, a sense that it moves or wiggles, gum recession that exposes the metal threads, swelling, or bleeding around the site all point to a problem. An implant that feels loose is the clearest sign and should be looked at quickly, because the longer a failing implant stays in, the more bone it can take with it.
Can a Failed Implant Be Saved?
Sometimes, yes. If the problem is early peri-implantitis and the implant is still solidly anchored, we can often treat the infection, clean the site, and adjust the prosthetic to save the implant. If the implant is mobile, never integrated, or too much bone has been lost, the implant has to come out. We can usually tell which situation you're in after a cone beam CT scan shows the bone around the implant in three dimensions. We will be straight with you about whether your implant is salvageable.
Your Implant Revision Surgeons in Honolulu
Dr. Todd K. Haruki and Dr. Neil Oishi both hold DDS and MD degrees and are Diplomates of the American Board of Oral and Maxillofacial Surgery. Revision cases are harder than first-time implant placement because the surgeon is working in a site already altered by the failed implant and often by bone loss. That work calls for the surgical training to manage compromised bone and the judgment to know when to rebuild a site versus when to wait.
Dr. Oishi is a Member of the International Team of Implantology, an evidence-based organization whose protocols on managing implant complications and failures directly inform how we approach revision cases.
Dr. Haruki founded Pacific Maxillofacial Center in 1999 and is a Fellow of the American Dental Society of Anesthesiology. Removing a failed implant and grafting the site can be more involved than the original placement, so the in-office IV sedation his anesthesia training supports keeps these longer appointments comfortable. We offer the full range of sedation options without referring out.
The Failed Implant Repair Process
Repairing a failed implant is rarely a single visit, because the site usually needs to heal before a new implant can go in. The process runs like this at our Honolulu and Waipi'o offices:
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Diagnosis and CBCT scan – We examine the implant and take a cone beam CT scan to see the bone around it in three dimensions. The scan tells us whether the implant can be saved and how much bone remains for a replacement. More on our diagnostic imaging technology.
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Treatment plan and sedation discussion – We walk you through what we found, whether the implant comes out or can be treated in place, and what the replacement timeline looks like. We do most revision surgeries under IV sedation, which we discuss at this visit.
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Implant removal – If the implant has to come out, we remove it carefully to preserve as much surrounding bone as possible. Protecting the remaining bone is what makes a future replacement possible.
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Bone grafting, if needed – When the failure has cost you bone, we place a bone graft to rebuild the site. The graft needs several months to mature before it can support a new implant.
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Healing period – We usually wait 3 to 6 months after removal or grafting before placing a replacement, so the new implant integrates into healthy, stable bone rather than a compromised site.
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Replacement implant placement – Once the site is ready, we place the new implant, often using our X-Guide 3D navigation system to position it precisely in the rebuilt bone. From there, your restorative dentist completes the crown or restoration. |
What Implant Revision Restores
 Fixing a failed implant does more than replace a tooth. It resolves the underlying problem and protects what is still healthy.
- It stops the infection and pain – Treating peri-implantitis or removing a failing implant ends the active infection that, left alone, keeps damaging the bone and gum. We confirm the source with the CBCT scan before we treat it.
- It protects the bone you have left – We remove failing implants carefully to preserve the surrounding socket walls and graft the site in the same practice, so the bone that's left can support a future implant instead of being lost to a lingering failure.
- It gives you a properly planned second implant – We plan the replacement from the CBCT scan and place it with X-Guide navigation, so the new implant goes into healthy bone in the right position rather than repeating whatever went wrong the first time.
- It restores function and confidence – Once the replacement integrates and your restorative dentist completes the crown, you're back to normal eating and speaking. Because we rebuilt and planned the site first, the new implant sits on a sound foundation rather than the one that failed.
We will not promise that every failed implant can be replaced. Occasionally a site has lost too much bone or sits too close to a nerve or sinus to support a new implant safely, and we will tell you honestly if that is the case and walk through the alternatives.
Why Choose Our Team for Implant Revision
A failed implant is not a routine placement, and it should not be treated like one. Working in bone that a previous failure has compromised is a different skill from placing an implant in fresh bone, and both of our surgeons are dual-degree DDS/MD oral and maxillofacial surgeons trained for exactly that.
A few specifics from our practice. We CBCT-scan every revision case to map the remaining bone and find the cause of the failure before we plan a fix. We rebuild deficient sites with bone grafting in the same practice, then place the replacement implant with X-Guide 3D navigation. And we handle the full range of sedation in-office, including IV sedation administered by Dr. Haruki's anesthesia-trained team, which keeps the longer revision appointments comfortable.
There is a reason general dentists across Honolulu and West Oahu refer failed-implant cases to an oral surgery practice rather than redoing them in-house. Revision work needs surgical training in bone management, 3D imaging, and the ability to graft and replace under one roof. That is the work we do every week.
Implant Revision Cost and Financing
Cost matters, and we want to be straight with you. The cost of repairing a failed implant depends on what the case needs: removal alone, removal plus bone grafting, the healing time, and the replacement implant itself. Some cases are straightforward; others need staged work over several months. We give you a written estimate once the CBCT scan shows exactly what your site requires.
Insurance coverage for revision work varies. Some plans treat the removal and replacement as medically necessary, especially when infection is involved, while others apply implant limitations. Our team verifies your benefits before treatment and explains what your plan covers. Our financial and insurance options cover accepted payment methods, and we can set up payment plans for the balance. Call our office to go over coverage for your specific case.
Schedule Your Implant Evaluation
If an implant feels loose, painful, or just wrong, don't wait. The sooner we evaluate it, the more bone we can usually save. Call us at 808-585-8455 or request an appointment online to schedule. Our Honolulu office is at 1060 Young St #312, Honolulu, HI 96814. Our Waipi'o office is at 94-1221 Ka Uka Blvd #B-204 in Waipahu, HI 96797. You can also contact us with any questions before booking.
Frequently Asked Questions
How do I know if my dental implant is failing?
The clearest sign is an implant that feels loose or moves, which should be checked right away. Other signs include pain, swelling, bleeding, or gum recession that exposes the metal threads. Some early peri-implantitis has no symptoms and shows up only on imaging, which is why we recommend a cone beam CT scan for any implant you're worried about.
Can a failed dental implant be saved?
A failed implant can sometimes be saved, and timing is the biggest factor. Caught early, an infection around a still-stable implant can often be cleaned and treated without removing it. Once the implant loosens or the bone support is gone, saving it is no longer possible. That is why a loose or aching implant is worth evaluating within days, not months.
Why did my dental implant fail?
The most common reason is peri-implantitis, an infection of the bone and gum around the implant. Other causes include the implant not fusing with the bone, a mechanical problem with the abutment, heavy bite force, or healing slowed by smoking or uncontrolled diabetes. Often we cannot be certain of the cause until we examine the site, but the CBCT scan and your history usually point to it. Implant failure is frequently nobody's fault.
Does removing a failed implant hurt?
During the removal, no. We fully numb the area, and most patients choose IV sedation so they have no memory of the procedure. Afterward, the discomfort is usually similar to a tooth extraction, manageable with over-the-counter or prescribed pain medication and ice for the first day or two. If we graft the site at the same time, recovery may take a little longer, and we go over what to expect before you leave.
How long after removal can I get a replacement implant?
In most cases we wait 3 to 6 months between removing a failed implant and placing a replacement, so the bone can heal and stabilize first. If the site needed a bone graft, the wait is on the longer end while the graft matures. Some straightforward cases without grafting can move faster. Rushing a replacement into a compromised site is the surest way to a second failure, so we let the bone lead the timeline.
Will I need a bone graft to replace a failed implant?
Not always. It depends on how much bone the failure cost. A clean removal with healthy bone left behind may need no graft at all. When a graft is needed, we place a bone graft and let it mature before the new implant goes in. The CBCT scan tells us which situation you're in before we plan anything.
Can every failed implant be replaced?
Most can, but not all. Occasionally a site has lost too much bone, or sits too close to a nerve or the sinus, to support a new implant safely even after grafting. In those cases we are honest about it and walk through alternatives like a bridge or a different restoration. For most patients, though, a well-planned replacement succeeds, and dental implant success rates are high overall.
Do I have to go back to the dentist who placed the original implant?
No. You can come to us directly for an evaluation, and many patients do exactly that. We handle revision cases referred by other dentists routinely and coordinate with your restorative dentist on the replacement when the time comes. There is no need to return to the original placer first, and we focus on fixing the problem rather than assigning blame for it. |
