Inappropriate and unnecessary implant therapy driven by an erroneous belief that dental implants provide enhanced function and esthetics over diseased or failing teeth has led to a growing burden of implant complications across the globe. Specifically, esthetic and biological complications frequently lead to the unfavorable prognosis of dental implants. Often, these cannot be managed predictably to improve the condition or satisfy patients' demands. In such circumstances, implant removal needs to be considered. Currently, minimally invasive methods based on reverse torque engineering are key to preserve peri-implant soft and hard tissues. Implant replacement is now feasible, as evidenced by the high survival rates of implants placed at previously failed sites. Notwithstanding these data, clinicians should still consider carefully the expendability of an implant and whether its replacement will satisfy the prosthetic, biomechanical, and esthetic demands of the patient. In the scenario where future implant placement is desired, protocols undertaken for soft/hard tissue grafting and implant placement should be based upon defect morphology and soft and hard-tissue characteristics. Currently, however, a lack of knowledge of the biological events and dimensional changes that arise following implant removal renders decision-making complex and challenging, and recommendations remain largely based upon empirical speculation. This chapter will review the indications for implant replacement for prosthetic, biomechanical, and esthetic complications, alongside considerations in decision-making, planning, implementation, and outcomes of implant replacement.

中文翻译：

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种植牙拔除的处理及后遗症

由于错误地认为种植牙比患病或衰竭的牙齿提供增强的功能和美观，导致不适当和不必要的种植治疗，导致全球种植并发症的负担越来越大。具体而言，美学和生物学并发症经常导致牙种植体的不良预后。通常，这些都无法以可预测的方式进行管理以改善病情或满足患者的需求。在这种情况下，需要考虑移除植入物。目前，基于反向扭矩工程的微创方法是保护种植体周围软硬组织的关键。植入物更换现在是可行的，这可以从先前失败部位的植入物的高存活率得到证明。尽管有这些数据，临床医生仍应仔细考虑植入物的可消耗性以及其更换是否能满足患者的修复体、生物力学和美学要求。在需要未来植入物的情况下，软/硬组织移植和植入物植入的方案应基于缺损形态和软组织和硬组织特征。然而，目前缺乏对植入物移除后出现的生物事件和尺寸变化的了解使得决策变得复杂且具有挑战性，并且建议仍然主要基于经验推测。本章将回顾假体、生物力学和美学并发症的种植体置换适应症，以及在决策、规划、实施、