Most people can replace a dental implant once, sometimes twice. It depends on how much bone you have left after the first one fails.
The more times an implant fails, the less bone remains. Bone is what holds the whole thing in place. Without enough bone, there’s nothing to anchor a new implant into.
This article breaks down exactly what happens when an implant fails, how many times replacement is realistic, and what the research actually says about long-term outcomes.
How long do dental implants actually last?
Dental implants last a long time. Studies show survival rates of around 94 to 97 percent over 10 years, and many implants stay healthy for 20 to 30 years or more.
A 2022 systematic review published in the Journal of Clinical Periodontology found that the 10-year implant survival rate across thousands of patients sat at 96.4 percent [1].
The implant itself, the titanium screw that goes into your jaw, is designed to be permanent. What wears out over time is the crown, the visible tooth on top. Crowns typically last 10 to 15 years before they need replacing, but swapping a crown is simple and doesn’t count as replacing the implant.
What happens to dental implants after 20 years?
After 20 years, most dental implants are still in place and working fine. The titanium fuses with your jawbone through a process called osseointegration, and once that bond forms, it’s strong. Your body treats the titanium like natural bone tissue.
That said, some things do change over two decades.
- The crown on top will likely need replacing at least once, sometimes twice
- Bone levels around the implant can slowly decrease, especially if gum disease goes untreated
- A condition called peri-implantitis, which is basically gum disease around an implant, can develop and damage the bone if left alone
- Natural aging changes the shape of your jaw and face, which can affect how the implant looks and sits
A long-term study from NYU College of Dentistry tracked patients for 16 years and found that implants placed with good bone support and regular maintenance had a failure rate of under 5 percent [2]. The patients who skipped check-ups or developed peri-implantitis had significantly higher failure rates.
The takeaway is clear. Implants placed properly and maintained well survive long-term. Neglect is the main reason they don’t.
At what stage do dental implants fail?
Implants fail at two different stages. Knowing which one matters a lot for whether replacement is possible.
Early failure (within the first few months)
Early failure happens before or shortly after the implant fuses with the bone. This usually occurs within the first three to six months. Causes include infection at the surgery site, the implant not integrating with the bone, too much pressure placed on the implant before it has healed, smoking, or uncontrolled diabetes affecting healing.
Early failure is actually easier to deal with. The bone is largely intact, so a replacement implant can often go in after a healing period of a few months.
Late failure (years after placement)
Late failure happens after the implant has been working fine for years. The main cause is peri-implantitis, an infection that destroys the bone around the implant over time. Jaw injury, excessive bite force, and certain medications that affect bone density can also cause late failure.
Late failure is harder to manage because bone loss has already happened. Replacing the implant may require a bone graft first, which adds cost, time, and another surgical procedure to the process.
Can a dental implant be removed and not replaced?
Yes, absolutely. Removing a failed implant and leaving the gap is a valid option, and plenty of people choose it. There’s no rule that says you must replace every implant that fails.
Reasons someone might choose not to replace include significant bone loss that makes replacement very difficult, high surgical risk due to medical conditions, cost, or simply personal preference.
If the gap is in a visible area or affects chewing, other options exist. A dental bridge uses the teeth on either side to support a false tooth in the middle. A partial denture is another option. Neither requires implant surgery.
For people missing most or all of their teeth, an All-on-4 treatment is worth knowing about. This approach places four implants in strategic positions in the jaw to support a full arch of teeth. Because the implants sit at angles that use available bone more efficiently, All-on-4 can work even when bone volume is limited. You can read more about this option at Genesis Dentists All-on-4 dental implants.
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What is the 3-2 rule for implants?
The 3-2 rule is a clinical guideline used in implant dentistry, particularly when planning implant-supported bridges or full-arch restorations. It means you need at least 3 implants to support a 3-unit bridge, and at least 2 implants on each side of the arch for a full-arch case.
Some clinicians apply it slightly differently depending on context, but the core idea is the same. You need enough implants spread across enough jaw positions to distribute bite force evenly. Overloading too few implants is one of the reasons implant systems fail.
In full-arch cases like All-on-4, the rule adapts. Four well-placed implants, angled to maximize contact with available bone, can support a full set of teeth because the load gets shared across the whole arch rather than concentrated in one spot.
How many times can you actually replace a failed implant?
Most dentists agree that one replacement attempt is realistic for most patients. Two attempts are possible if bone volume is good. Three or more replacements in the same site are rare and usually only attempted after significant bone grafting.
Here’s why the number is limited.
Every time an implant fails and gets removed, it leaves a socket in the bone. That socket takes time to heal, and even after healing, there is less bone volume than before. A smaller implant or a bone graft becomes necessary. Bone grafts work well, but they add healing time of three to six months and they don’t always integrate perfectly.
A 2019 study in the International Journal of Oral and Maxillofacial Implants looked at replacement implants specifically [3]. It found that replacement implants had a slightly higher failure rate than original implants, around 6 to 8 percent compared to 3 to 5 percent for first-time placements. After a second replacement, failure rates climbed higher still.
The bone in your lower jaw, the mandible, is generally denser than the bone in your upper jaw, which means lower jaw implants tend to integrate more reliably and tolerate replacement better. Upper jaw replacements in areas where bone is naturally softer carry more risk.
What increases your chances of a successful replacement implant?
Several factors push the odds in your favour.
- Treating the original cause first. If peri-implantitis caused the first failure, the infection must be fully cleared before placing a new implant. Placing into infected bone almost always fails.
- Waiting for proper healing. Rushing back in too quickly is a common mistake. Most sites need three to six months to heal properly after implant removal.
- Bone grafting when needed. If bone loss is significant, grafting before replacement improves integration. Skipping this step to save time or money usually ends in another failure.
- Not smoking. Smoking cuts blood supply to healing tissue and is one of the strongest predictors of implant failure. Studies consistently show smokers have failure rates two to three times higher than non-smokers.
- Managing systemic health. Uncontrolled diabetes, osteoporosis, and certain medications like bisphosphonates all affect bone healing. Getting these under control before surgery matters.
- Choosing an experienced implant surgeon. Placement technique directly affects outcomes. Implants placed by experienced oral surgeons or prosthodontists have lower failure rates than those placed by practitioners with less implant experience.
How much does implant replacement cost in Australia?
Replacing a failed implant costs more than the original placement because there are extra steps involved. In Australia, expect to pay roughly these amounts.
- Implant removal: $300 to $600 AUD
- Bone graft (if needed): $800 to $2,500 AUD
- Replacement implant and crown: $4,000 to $7,000 AUD
So a full replacement process, including bone grafting, can run $5,000 to $10,000 AUD or more depending on your situation. Some private health funds cover a portion of implant work under major dental, but coverage varies widely so check your policy directly.
Frequently asked questions
Can a failed implant be replaced immediately?
Rarely. Most sites need time to heal after removal. Immediate replacement is only considered when the bone is fully intact and there’s no infection. In most failure cases, waiting three to six months gives better results.
Does it hurt more to have an implant replaced than the original?
Not necessarily. The procedure uses the same local anaesthetic approach. What can make it more involved is the bone grafting step, which adds surgical time. Recovery after a replacement with grafting tends to take a bit longer than a straightforward first placement.
Will Medicare cover implant replacement in Australia?
Medicare does not cover dental implants or their replacement. Implants fall under private dental, not the Medicare Benefits Schedule. Some patients access the Child Dental Benefits Schedule for children, but this doesn’t cover implants either.
What are the signs a dental implant is failing?
Watch for pain or discomfort around the implant site that doesn’t settle, the implant feeling loose or moving when you press on it, swelling or bleeding gums around the implant, or a bad taste that persists near the site. Any of these needs a dentist appointment quickly. Catching problems early gives you more options.
Is an All-on-4 a better option if my implants keep failing?
For people who have lost several implants or who have significant bone loss across the jaw, looking after your implants can be a better solution than individual replacements. The angled implant design works with less bone, spreads load across the whole arch, and replaces all teeth at once rather than dealing with repeated single-implant failures.
The bottom line
You can replace a dental implant, usually once and sometimes twice, but bone loss sets a real limit on how many attempts are practical. Early failures with intact bone are easier to address than late failures where bone has already been lost to infection or trauma.
The best way to avoid the replacement question entirely is to look after your implants from day one. That means brushing, flossing, attending regular check-ups, and treating any sign of gum problems fast.
If you’re dealing with a failed implant or want to understand your options for replacing multiple missing teeth, speaking with an experienced implant dentist is the right first step.
Ready to Take the Next Step for Your Dental Health?
Talk with our team about your concerns and the most appropriate next step.
