To Remove or Not Remove Non‐Conventional Dental Implants? Eleven‐Year Retrospective Study on Implant Outcomes

ABSTRACT Dental implants have become the gold standard for tooth replacement, and there are various designs for them. However, mechanical and biologic complications can necessitate implant removal. Aim To assess the challenges of dental implant removal according to implant designs through 11 years of data collected via a single‐center study. Materials and Methods A retrospective study of patients that required dental implant removal between the years 2014 and 2024. Individuals with non‐conventional implant designs, like subperiosteal, blade (basal), and broken root‐form implants, were selected for the case series description. The analysis included details regarding the mechanical and biological determinants of the implant removal and the rehabilitation following the removal. Results Two hundred and sixty‐four patients (mean age 66.78 years Range 32–87, SD 9.85) were screened, and 503 implants were removed between the years 2014 and 2024—among which 40 were non‐conventional designs. Broken osseointegrated implants are among the most challenging to remove. Case series of the removal of these non‐conventional designs are described. There are substantial bone defect consequences in cases of basal implants, and the possibility for reimplantation is low. Cases demonstrating the preservation of zygomatic implants with complications are also presented. Conclusions The removal of broken osseointegrated dental implants, particularly screw‐type implants, poses significant challenges due to their integration with the surrounding bone tissue. Similarly, non‐conventional implant designs such as zygomatic implants, which are larger in size and located near vital anatomical structures, carry a heightened risk of complications during removal. The preservation of zygomatic implants is recommended due to the bone defects that could result from their removal. Therefore, it is crucial for clinicians to carefully consider the selection of implant designs and sizes prior to implantation. This decision‐making process should be informed by an understanding of the potential difficulties and risks associated with implant removal in the event of failure. Clinical Relevance In everyday dental practice, clinicians frequently encounter the need to remove various types of implants, and it is important for them to be aware of and understand potential challenges before such procedures are performed.