By 부평나우치과••Updated: 7/17/2026

Bubyeong Implant Revision Surgery, What Process Does It Go Through? — From Peri-implantitis to Re-osseointegration

What is Implant Revision Surgery?

Implant revision surgery is a treatment process in which inflammation or bone loss occurs around an existing implant, the fixture is removed, and then re-implanted, requiring higher difficulty than the initial surgery.

Implants are an excellent treatment option to replace natural teeth, but when used long-term, problems can develop in the surrounding tissues due to various causes. Representative causes include peri-implantitis, insufficient osseointegration, excessive occlusal force, and neglect of oral hygiene management. As these problems progress, the gums around the implant may swell, pus may accumulate, and severe pain may occur. In some cases, the fixture must be completely removed before deciding whether to re-implant.

According to academic literature, the success rate of implant revision surgery is generally reported to be 10-20 percentage points lower compared to initial surgery. Therefore, revision surgery cases require even more precise diagnosis and staged treatment planning. Now dental clinic (a dental clinic specializing in implants and oral surgery) has an oral and maxillofacial surgeon on-site to conduct systematic approaches to complex revision surgery cases.

Peri-implantitis, Why Does It Occur?

Peri-implantitis is an inflammatory disease that occurs in tissues around an implant. If left untreated, the surrounding bone tissue can be rapidly resorbed, making fixture removal inevitable.

Peri-implantitis begins when plaque and bacteria accumulate in the space between the implant and the gums. Initially, it remains in the stage of peri-implant mucositis where the gums become swollen and bleeding occurs, but if appropriate treatment is not provided, it progresses to peri-implantitis, which destroys the bone tissue.

The main risk factors for peri-implantitis are as follows.

  • Poor oral hygiene: Continuous accumulation of bacterial biofilm around the implant

  • Smoking: Reduced healing ability due to decreased blood flow

  • Systemic diseases such as diabetes: Reduced immune response

  • Inappropriate prosthetic design: Creating an environment for food debris accumulation

  • Excessive occlusal force: Continuous stress on bone tissue around the fixture

After implant placement, follow-up examinations at 3-6 month intervals are recommended to continuously monitor the condition of surrounding tissues. The earlier it is detected, the higher the possibility of inhibiting progression through non-surgical methods without surgical intervention.

Implant Revision Surgery Staged Treatment Process

Implant revision surgery proceeds in the order of removing the inflamed implant, bone grafting, waiting for bone healing, and re-implantation. Alone, the bone healing period after bone grafting can take an average of 4-6 months.

Implant revision surgery is not simply a matter of re-inserting a new fixture. Stable re-implantation is only possible after completely restoring tissue damaged by inflammation, so the following steps are involved.

Step 1: Precise Diagnosis and Treatment Plan Establishment

Through 3D CT imaging and digital image analysis, the extent of bone loss, distance from adjacent teeth and inferior alveolar canal, and amount of remaining bone are accurately identified. At this stage, whether revision surgery is possible and whether bone grafting is needed are determined.

Step 2: Problem Implant Removal and Lesion Treatment

Inflammatory tissue is thoroughly removed, and prosthetic handling such as bridge sectioning is performed first if necessary. The affected area is thoroughly disinfected and granulation tissue is removed to create an environment suitable for grafting.

Step 3: Bone Grafting (Osseointegration)

When bone loss is severe, bone grafting using artificial bone graft material or autologous bone is necessary. In this process, AFG (Autologous Fibrin Glue) extracted from the patient's own blood may be mixed with the bone graft material. Since AFG uses autologous blood components, the risk of rejection is low, and it can help stabilize the graft material in the bone defect area and promote bone cell differentiation.

Step 4: Waiting for Bone Healing

An average of 4-6 months of healing time is needed for sufficient bone formation after bone grafting. During this period, the progress of bone healing is monitored through periodic radiographic imaging.

Step 5: Implant Re-implantation

Once sufficient bone healing is confirmed, a new fixture is implanted. During implantation, accurate surgery that takes into account all three elements of position, angle, and depth must be performed. For areas where occlusal force is concentrated, such as molars, a tissue level implant may be more appropriate than a bone level implant.

Step 6: Prosthetics and Long-term Management

After bone osseointegration is complete, prosthetic aids (crown) are fabricated and installed, and long-term stability is monitored through follow-up examinations.

Comparison of Bone Grafting Methods: What Are the Differences?

The choice of bone grafting material and method should be determined by comprehensively considering the extent of bone loss, the patient's systemic health status, healing period, and other factors.

Bone grafting in implant revision surgery is a key step that determines success or failure. The table below compares the characteristics of major bone grafting methods.

Classification

Autologous Bone Graft

Allograft

Xenograft

Synthetic Bone Graft

Source of Bone Material

Patient's own body

Human donor tissue

Animal (cattle, pigs, etc.)

Artificial synthetic material

Bone Induction Capacity

High

Moderate

Low to Moderate

Low

Rejection Risk

None

Low

Low

Very Low

Additional Harvesting Surgery

Required

Not Required

Not Required

Not Required

Absorption Rate

Relatively fast

Moderate

Slow

Varies by material

Cost Range

Moderate

Moderate to High

Moderate

Low to Moderate

Main Suitable Candidates

Extensive bone loss, good systemic health

Moderate bone loss

Sites where bone maintenance is important

Supplementing minor bone loss

Which graft material is suitable should be determined after comprehensively evaluating the extent and location of bone loss, the patient's systemic health status, healing ability, and other factors, followed by sufficient consultation with a specialist.

Tissue Level Implant vs Bone Level Implant

In areas where occlusal force is concentrated, such as molars, a tissue level implant can be an advantageous choice under specific clinical conditions.

The choice of fixture type during implant revision surgery is also an important consideration. The commonly used Bone Level implant and Tissue Level implant differ in structural characteristics and application situations.

Comparison Item

Bone Level Implant

Tissue Level Implant

Fixture Position

Embedded at bone level

Partially exposed at gum level

Prosthetic Flexibility

High (various angle adjustments possible)

Relatively limited

Soft Tissue Management

More detailed management needed

Advantageous for maintaining gum shape

Application in Molar Area

Fixture fracture risk to consider depending on case

Advantageous structure for distributing occlusal force

Aesthetic Demand

Preferred when high aesthetics required

Suitable for molar functional recovery

Bone Resorption Pattern

Can be minimized with design

Can maintain stable bone level

When re-implanting a single implant in an area like molars where strong occlusal force is applied, a tissue level implant may help reduce fixture fracture risk in certain clinical situations. However, the final choice should be made after careful evaluation of the patient's individual oral structure and remaining bone condition.

Post-Implant Revision Surgery Management Methods

Even after successful implant revision surgery, proper post-operative care and meticulous oral hygiene management over at least 6 months to 1 year intervals are key factors that determine long-term prognosis.

Even if revision surgery is completed successfully, the prognosis can vary greatly depending on subsequent management. It is important to consistently practice the following in daily life.

Daily Oral Hygiene Management

  • Thorough cleaning using implant-specific toothbrushes or interdental brushes

  • Brushing at least twice daily, preferably within 30 minutes after meals

  • Cleaning of adjacent surfaces using dental floss or water pick

Lifestyle Habit Improvement

  • Smoking reduces blood flow around implants and can hinder osseointegration and healing, so smoking cessation is recommended

  • Avoid excessive consumption of hard or tough foods

  • If bruxism occurs, consider wearing a night guard

Regular Follow-up Examinations

  • Radiographic imaging and periodontal status check at minimum 6-month to 1-year intervals

  • Immediate visit to the clinic if abnormal symptoms occur (looseness, pain, gum swelling)

Now dental clinic (a dental clinic specializing in implants and oral surgery) provides systematic maintenance protocols including follow-up examinations at 1 year post-prosthetic placement after implant procedures.

Frequently Asked Questions (FAQ)

Do I have to undergo revision surgery if peri-implantitis develops?

Not all cases of peri-implantitis require revision surgery. The treatment direction varies depending on the degree of inflammation progression. If the inflammation is limited to the early stage affecting only the gums (peri-implant mucositis), management through non-surgical methods such as scaling and medication may be possible. However, when bone loss has already progressed significantly and the stability of the fixture is greatly reduced, surgical treatment including implant removal and re-implantation may be necessary. It is important to first understand the exact condition through radiographic images and clinical examination.

Is implant revision surgery possible even if a lot of jawbone has been lost?

Implant re-implantation is often possible even when remaining bone volume is insufficient by performing bone grafting first. However, the treatment plan varies depending on the extent of bone loss, distance from adjacent anatomical structures (inferior alveolar nerve, maxillary sinus, etc.), and the patient's systemic health status. An average period of 4-6 months is needed after bone grafting until sufficient bone formation is confirmed, during which regular follow-up observations are conducted. It is advisable to first receive a precise evaluation through 3D CT.

How long does it take from implant revision surgery to completion of prosthetics?

The overall treatment period for implant revision surgery varies depending on the individual's bone healing rate, necessity of bone grafting, and extent of inflammation, but generally takes 6 months to 8 months or more from bone grafting to prosthetic completion. This is because 3-4 months are needed to confirm bone formation after bone grafting, and an additional 3-4 months are needed to confirm osseointegration after re-implantation. Rapid progression increases the risk of re-failure, so it is important to adequately go through each step for long-term stability.

I'm afraid of dental treatment. How is pain management handled during implant revision surgery?

Implant revision surgery may have a wider incision range than initial surgery, which may feel more burdensome for those with dental treatment fear. Now dental clinic (a dental clinic specializing in implants and oral surgery) can apply conscious sedation throughout the entire treatment process, including implant revision surgery, for patients with severe anxiety or fear of dental treatment. Conscious sedation is different from complete general anesthesia; it maintains consciousness while significantly reducing anxiety and discomfort to allow patients to undergo treatment. Please confirm through consultation with a specialist which pain management method is suitable for you.

How much does implant revision surgery cost?

Implant revision surgery costs vary depending on the extent of bone loss, type and amount of bone graft material, implant system used, and whether additional procedures (such as AFG) are performed, so there is no uniform fixed price. Since non-covered items are often included, it is advisable to receive accurate cost information based on individual treatment planning after a detailed examination. Please confirm the treatment plan suitable for your condition and expected cost range through consultation.

Treatment results may vary depending on individual health status, so please consult with a specialist.

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