What is your Failed Implant Policy?

I am curious as to how other offices handle failed implant cases. What kind of fee, if any, do you make for replacement? How do you handle additional procedures such as grafting of the failed site?

22 thoughts on “What is your Failed Implant Policy?

  1. Eric Ruckert, DDS says:

    As an oral surgeon, I “guarantee” them for one year. If it fails, I do a new one for free or give them 1/2 the money back for a bridge or whatever. (so far the failures are failure to integrate and within the first 3 months) After one year it is always a perio problem, so they sign a ‘longevity’ consent that indicates they must take perfect care of the area, floss, waterpik, etc. I have done 1065 implants and all but 3 are still present, with the average age of 8 years, and some 23 years. Four I re-did for free and they worked the second time (waited longer for integration, or pt anemic, or osteoporotic, Only one mechanical failure (the screw).

    • Periogirl says:

      I follow the same policy as Dr. Ruckert. Generally I have a 1-year ‘guarantee’. This is dependent on the patient following my post op instructions and not doing something foolish, not skipping post op visits, etc..That means I will remove the implant, graft at no charge and again no charge at the surgical visit where the second implant is placed. The implant company will supply me with a new implant. This doesn’t happen often but I feel patients do appreciate this.

    • Mike says:

      Dear Dr Ruckert
      I am impressed with your success rate, which Implant system or systems do you use?
      Many thanks

      • Eric Ruckert says:

        Zimmer. But I think the success rate is a learned thing, ie I try not to do immediates, I always graft all sockets (Puros), I wait longer for healing than I used to. Usually 4 months for bone healing, and four months for integration, a bit longer if lots of bone used like a ridge graft, or open sinus graft, or med. issues, or osteoporosis.

  2. dds says:

    We follow the same protocol as the medical profession. Only death and taxes are guaranteed. Obviously one must be confident that he/she provided care according to prevailing standards. Arguments will always be presented and therefore confidence is of utmost importance. Ignoring payment for re-treatment is potentially an admission for a contribution to the failure. Depending on circumstances a gesture of compassion is considered and some discount applied following an in-depth explanation. The element of patient compliance with post operative directions should also be considered. A well designed consent form is a must and the office policy should be clear and detailed.

  3. Don Rothenberg says:

    Our policy would be to replace the implant at no charge in the first year, at 1/2 cost in the next 2 years.
    Since 1986, when I started doing implants we have replaced about 6 implants in the first year and 4 after 2 years.
    We have had some problems (approx. 10) 10-20 years out.
    Since 1986 we have place 6000+ implants, the failure rate is extremely low.
    I’m grateful for this and so are my patients.

  4. adil albaghdadi says:

    one year satisfaction guaranteed to re do it again at no charge if the patient accept full treatment plan. and life time for patients who keep coming to my office every 3 months for perio maintenance. post operative and post prosthetic instructions provided should be followed.

  5. Dr. Gerald Rudick says:

    Those of us who practice implant dentistry are doing it because we have a passion for this discipline of dentistry….. we want to succeed……money is important and necessary, but more important is that we want to make our patients happy and change their lives for the better.
    Most dental implant manufacturers have a very fair return and replace policy…. if it fails, they will send the dentist a replacement at no cost.

    In the area where I practice, our licensing body is called the Quebec Order of Dentists, and if they get wind of a dentist giving a guarantee….they will haul the dentist into their Disciplinary Court, put him/her through an expensive Disciplinary Hearing, (which they always win) and subject the dentist to a hefty fine…..So….GIVING A GUARTANTEE IS CONSIDERED ILLEGAL FOR ANY PROFESSIONAL.

    In your consent form, you can write in a “replacement policy clause”….as long as you do not call it a guarantee, and describe the terms and circumstances.

    As was mentioned above, generally if an implant is not going to integrate and become useful, it generally happens before the final restoration is made… so there is no lab fees involved….. and if there is a lab fee, generally there are salvageable and reusable parts especially if it is a screw retained restoration.
    It is not expensive for the dentist to go back in and make the patient happy with little or no fees……. they will appreciate that you are concerned about their welfare, and reward you with plenty of referrals.

    • adil albaghdadi says:

      satisfaction guarantee is( patient and dentist satisfaction) no guarantee in surgical dental procedures. hope that would be simple to understand.

  6. Bruce Lish DDS says:

    Since I place and restore the implants I will redo a failed implant if it doesn’t integrate at no charge. Within 1 year of loading if patient is compliant with home care and recommended recalls ill redo and redo crown, patient only pays material cost. After the year the full fee, it’s all on the patient. This is all stated in the financial agreement that goes with the consent.

  7. Marcus says:

    Gerald, I’m in Ontario and an OMS. I warranty implants to the point of osseointegration and aesthetic expectations. The RCDSO as far as I can tell is not against good Dentistry. I’m not sure what provision in your College disallows this. That’s crazy! Whilst you can’t gurantee something, you can certainly warrant the usability of the product. In fact, without such care, you could get away with the worst dentistry in the world and have no accountability. Perhaps the difference is warranty vs guarantee(?). I don’t see how it should be fair for a patient to have to be on the hook for an implant that someone placed without usability. That’s obnoxious.

    If there were patient factors that led to the failure than that should have been discussed at the consult or the decision made to not place at all. If there were surgical/anatomical factors again these should have been figured out ahead of time. For example, if you place a 4 mm implant in 5 mm of bone that’s your problem not the patient’s. Shame on you for subjecting the patient to $2000 more for an implant in that situation!

    I bought out a specialty practice and I still replace implants from my predecessor if they have short-term failure (<5 years). How can you in any degree of conscience sell a patient on a "permanent tooth replacement" then reneg when the thing fails after a year? That's offensive to this profession! When patients ask "what's the success rate?" I'm willing to bet most people quote "95% and higher".
    Well how do you reconcile that if a patient has a failure in a year? If you aren't willing to put your practice's money where it's mouth is then do dentistry a favor and don't place implants. Five thousand dollars for a restored implant is a LOT of money for people. Please think about that.

  8. Rand says:

    As Healthcare professionals we are always subject to the laws regarding malpractice. If we offer a warranty commercial laws come into effect. A malpractice attorney will always or a professional to never offer a warranty because it opens up all sorts of other legal Avenues which can be used against you.

  9. TK Diplomate, ABOI says:

    I / C must sign first, 3 months recall
    fail within 1st year after loading -> no charge
    fail within 2nd year loading -> materials cost only
    other than that is full price.

  10. Geoff says:

    After the implant is placed, the patient is offered free 3 month follow ups for the fist year. If they comply with that and are taking good care, I’ll replace it for free. I am the surgeon (though some ask me to restore too), but I have to make sure that the occlusion is correct, that they are flossing to a non-bleeding (including interdental) level. Because if I don’t follow up, the I won’t see the problem till it’s too late…and the dentist sends them back because my implant failed. If they are coming back to me every 3 months, I can pick up the problem and generally not have to graft, but just place another implant (for free in the first year). I don’t know if you all have seen Dr. Randolph Resnik’s article (in Glidewell lab’s periodical). If you follow those guidelines, you won’t have many failures. It’s the best review of implant planning I’ve seen. One of the major problems implants are suffering from is large occlusal tables with steep, angular cusps on posterior crowns. Implants can’t take those off angle forces. Even if they don’t have lateral interferences, if a piece of almond or peanut gets caught on those steep angles, that can generate a lot of off angle forces. Make occlusal table flattened and narrow so the food can “shed” off the surface and not get caught. Even my own lab likes to make them like crowns on teeth when I say “flattened, narrowed occlusal surface” and make a drawing. I find myself reducing them in many cases. If you do 3 month follow up with radiograph, you’ll notice bone loss early and look for the cause before it fails all the way. It’s usually occlusal trauma or plaque control or, longer term, excess cement.

  11. Dr. TK says:

    I offer no written policy for services following failed implants, and my informed consent forms state that I cannot guarantee that their body will accept an implant. However, in the event of a failure, I have always repeated surgery at no charge. For implant restorative failures I ask myself the question “should this have broken?” and treat case by case. Broken UCLA abutment on a screw retained crown? Should not have happened – no charge. Dropped an implant retained denture in the sink? That is on the patient.

    I have a referral based office, and upset patients cost me profoundly more than replacing an implant. I have placed implants for about ten years, so I am coming due for some long term failures. I suspect that I will remove them at no charge, but charge to replace them.

  12. Dr. Gerald Rudick says:

    Attention Marcus…
    Please reread what I wrote…..Giving a written guarantee is against the law for any professional in Quebec!!!! be it a dentist, a physician, a lawyer,etc……. but I did mention putting in the consent form a “replacement policy clause”…..just don’t call it a guarantee….and yes, every implant patient is entitled to a no charge replacement within a certain time delay, and the patient’s obligation is to respect the work that was done, and put a conscious effort into proper maintenance.

    You do not want to put a warrantee on a case where the patient is so happy with his new implant supported crowns that he is busy opening beer bottler with his implanted teeth.

  13. doc says:

    Interesting comments, particularly about laws and “legal” warranties. Having placed a few thousand implants in around a few thousand patients, making ANY guarantee is unwise, period! Total knees, hips, shoulders and all manner of other implanted medical devices fail, and since most are placed in “insured” patients, they are not replaced “free”. And these medical devices are far more costly, and OR time far more expensive for “redos”, so there’s just no way to make them free. But this is an entitled society we live in today. As for dental implants, while the oral cavity is a very accommodating and highly successful site for implantation, , it is still a clean contaminated environment and by its very nature still will have a certain percentage of biological, physiological, and infectious failures. There is no way to “predict” them, even with the battery of serum testing I’ve know some doing implants perform, looking for everything from anemia to allergies to DM. Keep guarantees limited to wash machines, automobiles, and inanimate objects.

  14. Peter Fairbairn says:

    We do standard 10 years warranty and 5 years on the restoration ( porcelain ) , redid one I placed 17 years ago and charged half price ……oh and have placed in the same office for 26 years …
    do a handful or so re – dos a year

  15. Dr. HArold Bergman says:

    I have been placing implants for 45 years and had a 2 page warranty which covered up to 5 years. It seemed to work well. If you want a copy, please email me


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