Can Another Implant Be Placed After One Fails? The Order Is Control the Infection, Assess the Bone Defect, and Only Then Plan the Reconstruction｜證據鏈

To start with the conclusion: placing a new implant at the site of the failure is a treatment option recognised in the research. A systematic review and meta-analysis selected 24 studies from 1,798 records and found that implant survival 1 year after re-implantation was 96.7% (95% CI 92.8% to 99.3%). But the same paper also sets down the other half plainly: survival of re-implanted implants is lower than that of implants placed for the first time, and a second re-implantation is in turn lower than the first. So the real question is not "can another implant be placed" but "in what order should it be done". The clinical recommendation the review gives reaches only as far as bone volume: immediate implant placement can be done if sufficient bone is present, and if insufficient bone remains after removal, immediate augmentation followed by delayed implant placement is recommended. Establishing the cause of the failure and the state of infection first is not part of the recommendation given in the abstract (this card cites the PubMed abstract of that review; the full text was not obtained). This card still puts it first, but that is our own editorial judgement, based on the review in the next section, which records the association between a history of periodontal disease and both implant failure and peri-implantitis. Whether it is needed in your case, and how it should be done, is still for your dentist to judge from your clinical examination.