title: Clinical Decisions: Determining When to Save or Remove an Ailing Implant.
abstract: The basis for the decision to either save or remove an ailing implant is multifactorial, and, as such, it has become one of the more controversial topics in the field of dental implantology. While bone lost to peri-implant disease can now be augmented with increasing predictability, the degree of success still varies depending on the size and configuration of the osseous defect. Concurrently, with the development of improved high-reverse torque instrumentation, minimally invasive techniques can be used to easily remove an implant that is malpositioned, causing an esthetic problem, or showing advanced bone loss. Any eventual decision regarding the retention or removal of an ailing implant must also be balanced with the desires of the patient, who typically will have already invested significant time and money to have the implant initially placed and restored. This article will present the variables involved in the decision-making process for when to save or remove an ailing implant. Clinical examples illustrating the management for these factors will be offered, providing clinicians a variety of alternatives available for managing different clinical circumstances that may be encountered.
authors.affiliation: Clinical Professor, Director of Implant Education, Columbia University College of Dental Medicine, New York, New York.
authors.forename: Dennis P
authors.initials: DP
authors.lastname: Tarnow
authors.affiliation: Adjunct Clinical Professor, Department of Prosthodontics, Ashman Department of Periodontology and Implant Dentistry, New York University College of Dentistry, New York, New York.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Chu
authors.affiliation: Clinical Associate Professor, Department of Periodontics, Columbia University College of Dental Medicine, New York, New York.
authors.forename: Paul D
authors.initials: PD
authors.lastname: Fletcher
mesh_terms: D003657:Decision Making; D003758:Dental Implantation, Endosseous; D015921:Dental Implants; D019232:Dental Restoration Failure; D020878:Device Removal; D006801:Humans; D012307:Risk Factors
chemical_list: D015921:Dental Implants