Every winter, freeze-and-thaw turns pavements into sheet ice, and every winter we treat people who have fallen on it. A broken front tooth is an emergency — but when the broken tooth is an existing implant, the treatment is very different from replacing a natural one.
On arrival
The patient arrived after a fall, with a badly swollen and torn lip and significant bleeding. Pain was severe and immediate treatment was needed.
With trauma of this kind, the visible damage is never the whole picture. Other teeth may have fractured below the gumline or cracked, and alveolar or facial bone fractures can accompany the injury. So after bleeding was controlled, the whole area was examined and imaged.
The findings: the artificial tooth in the front had fractured, leaving only the root portion in place; the crowns on the two adjacent teeth had come off; and the inner surface of the lip where it met the teeth was lacerated. Nothing else was cracked or broken.
How is anaesthesia handled when you are already in pain?
Anaesthetising a torn lip requires several injections into tissue that is already painful. We have a range of options for exactly this situation: topical anaesthetic applied before the needle, a computer-controlled painless injection system, and conscious sedation administered under an anaesthetist.
Given the shock of the accident and the level of pain, sedation was agreed with the patient, and the fractured fixture was removed with immediate implant placement in the same session.
Why did the whole implant have to come out?
Not every broken implant needs the fixture replaced. If only the upper prosthetic has broken, the connecting screw is loosened and a new abutment and crown are fitted — a straightforward repair.
Here, the screw and the abutment connecting the prosthetic to the body had both fractured, and the inner surface of the fixture itself was damaged. That leaves no way to attach anything to it. The fixture had to be removed.
Removing an integrated fixture is demanding work. A natural tooth sits in bone connected by the periodontal ligament, an elastic fibrous tissue — extraction means severing that connection. An implant has no such tissue: the fixture surface is fused directly to bone, so it does not simply come out, and some surrounding bone often has to be removed with it. Reverse drilling does not reliably work.
Front teeth make it harder still. Bone width is narrower than in the molar region, and the aesthetic angle and position have to be right, not merely functional.
We tried to retrieve the broken screw fragment first — ultrasonic vibration, then fine instruments to work the fragment loose. Neither succeeded, so the fixture body was removed, taking away as little surrounding bone as possible.
There is no charge for fixture removal.
Can an implant be replaced immediately?
Computer analysis established the remaining bone condition and the ideal position and angle, and a new fixture was placed under digital guidance.
A wider and longer fixture than the previous one was placed into a site with good bone quality, so that bone surrounded it without gaps. Initial stability was strong enough that a healing abutment could be fitted immediately.
Not leaving the patient without a front tooth
Osseointegration still needs time. During that period the adjacent prepared teeth were linked to carry a temporary tooth, so the patient was never without a front tooth — and the temporary was shaped deliberately to guide the gum line into a harmonious contour for the final restoration.
Because initial stability was high, integration progressed quickly. Two months later the stability reading confirmed the fixture could bear occlusal load, and the final prosthetic was fitted.
Frequently asked questions
My implant crown broke. Does the whole implant need replacing?
Not necessarily. If only the crown or abutment above the gum has broken, the screw is loosened and a new abutment and crown are fitted. The fixture only has to be removed when the screw or abutment fractures inside it, or the fixture’s internal surface is damaged, leaving nothing to attach to.
Is removing a failed implant expensive?
We do not charge for fixture removal. The cost that follows is for the replacement implant and prosthetic, and depends on whether bone grafting is needed at the site.
Will I be without a front tooth during treatment?
No. A temporary tooth is fitted for the healing period — here it was supported by the adjacent teeth. It also shapes the gum line while the site heals, which affects how natural the final crown looks.
How quickly can a fractured front implant be replaced?
Where bone quality allows, the old fixture is removed and a new one placed in the same session. In this case the final prosthetic followed two months later, because initial stability was strong. Sites needing bone grafting take longer.
I have had a dental accident in Korea. What should I do first?
Get seen the same day. Bleeding needs controlling and the full extent of the injury assessed — adjacent teeth, roots and bone can be damaged in ways that are not visible. If you are visiting Korea, call the clinic before travelling to it so we can prepare for your arrival.
Read more: implant revision · emergency dental care · digital guided implants