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Dr Manesh Lahori

Authors : Dr. Manesh Lahori


The global failure rate for dental implants has been reported to be between 2-9%. An estimated 200,000 to 250,000 implants are likely to fail annually worldwide.

As aptly quoted by Sir Benjamin Franklin, an implant clinician must be prepared to deal with a failing (mobile implant) or an improperly placed implant. Often times we come across situations where implant removal is the protocol (unless it can be left in the jaw bone as a sleeper implant) before the definitive treatment is rendered.

An implant may be removed by either one or a combination of techniques:-
  1.              Counter-Torque Ratchet Technique (CTRT)
    CTRT is the least invasive technique for removing an implant without damaging surrounding structures. The use of CTRT should be considered only if the implant is able to be engaged and reverse-torqued until mobile.

  2.              The reverse screw technique (RST)
    RST is another less invasive method that uses a screw removal device. RST is indicated in the removal of a fractured implant when the connection is damaged or in the removal of an external connection implant when the ratchet cannot be engaged to use the CTRT

  3.              Piezo Tips
    Piezo tips allow for better intra operative control during bone-cutting because they prevent damage to the surrounding soft tissue. Furthermore, the bone healing response following piezoelectric surgery seems to be more favorable than osteotomies performed with burs.

  4.              High-Speed Burs
    The use of high-speed burs under copious irrigation is an efficient method to remove a failed implant. Usually a long, thin diamond bur is preferred over a carbide bur, because the diamond bur is easier to control and produces a more efficient, thinner cut.

  5.              Trephine Burs
    Several sizes of trephines are available corresponding to various implant diameters .The smallest effective size trephine should be selected to avoid collateral damage to the neighboring bone, teeth, and/or implants.

This is one of the most invasive options for implant removal.


Dr. Manish Lahori
Dr. Manesh Lahori
B.D.S, M.D.S, F.I.S.O.I, F.I.C.O.I
Professor & H.O.D
Dept. of Prosthodontics
K.D Dental College, Mathura, India