A Clear Guide to Revision Treatment with Dr Ali Direnç Ulaşan – Milim Dental, Bursa

More and more patients arrive at Milim Dental in Bursa, Turkey with the same sentence:

“I already have dental implants… but I’m not happy with them at all.

Can anything be done, or do I have to live like this forever?”

Sometimes the problem is pain or infection.

Sometimes it is aesthetic disappointment – the teeth look fake, the smile is uneven.

Sometimes the implants were placed years ago and things have gradually deteriorated.

If you are reading this, you might recognise yourself in one of these situations:

Crowns or bridges on implants feel bulky, unnatural or too big

The colour does not match your face or remaining teeth

You have bad breath, bleeding or pus around implants

You feel pain or pressure when chewing

Food constantly gets trapped under the bridge

You are afraid the implants are “failing”, but you don’t know what to do

This article will guide you step by step through:

The most common reasons patients are unhappy with their existing implants

What can realistically be corrected without removing implants

When implants themselves must be treated or replaced

How revision implant treatment is planned at Milim Dental, Bursa

Why working with an experienced oral & maxillofacial surgeon like Dr Ali Direnç Ulaşan is crucial in complex cases

The aim is simple:

You should finish this article thinking “There is a structured way forward”, not “I’m stuck with this forever”.

1. Why Patients Become Unhappy with Previous Dental Implants

Before talking about solutions, it helps to understand the different types of problems.

Most complaints fall into one or more of these categories:

A. Aesthetic Problems

Crowns or bridges are too big, too long or too short

Teeth are too white, too opaque or the wrong shade for your face

Midline is off – the “centre” of the smile is not aligned with the face

Gum line is uneven or shows dark triangles between teeth

Metal shows at the gum line in old restorations

Result:

You don’t like your smile in photos, you feel self-conscious, and you avoid smiling naturally.

B. Functional Problems

Difficulty chewing comfortably on one or both sides

Bite feels “wrong” or unstable

You hear clicking, feel pressure or pain when biting

You grind or clench and the implants or crowns feel stressed

Result:

You don’t trust your bite, mealtimes are stressful, and you fear breaking something.

C. Biological / Health Problems

Bleeding, swelling or pus around implants

Persistent bad breath or bad taste

Pain or deep discomfort around one or more implants

Loose screws, broken screws or broken prostheses

X-rays show bone loss around implants (peri-implantitis)

Result:

You worry about losing the implant, damaging your jaw bone, or needing major surgery in the future.

D. Psychological Problems

After a bad experience, many patients feel:

Disappointed and betrayed – “I trusted that clinic, and now look at this.”

Anxious – “What if the new treatment fails again?”

Confused – different dentists say different things about what went wrong.

It is completely normal to feel this way. Part of our job at Milim Dental Bursa is to:

Listen carefully

Explain clearly

Rebuild trust step by step

2. First Step: A Detailed Assessment – Not Guesswork

Correcting previous implant work is very different from starting a simple new case.

This is why Dr Ali Direnç Ulaşan, oral & maxillofacial surgeon at Milim Dental in Bursa, follows a strict and systematic assessment protocol.

2.1 Clinical Examination

We start with:

Full inspection of all implants, crowns, bridges and natural teeth

Checking for tenderness, mobility, gum health and biting contacts

Assessing smile line, lip support and facial aesthetics

We are not only looking at what you don’t like – we are also trying to understand why it turned out this way.

2.2 X-Rays and 3D Imaging

We normally require:

A panoramic X-ray as a general overview

A CBCT (3D scan) in complex or doubtful areas

On the scans we can evaluate:

Position and angulation of each implant

Amount of bone around the implants

Presence of bone loss, peri-implant defects or hidden infection

Relationship to important anatomical structures (nerves, sinuses, etc.)

This is crucial to decide:

Which implants are healthy and usable

Which implants are compromised but possibly salvageable

Which implants are so badly placed or infected that they should be removed

2.3 Documentation and Photos

We also take:

High-quality intraoral and smile photos

Sometimes videos of speech and smile dynamics

This helps us plan aesthetics and explain options to you clearly.

3. The Good News: Often We Can Keep Your Existing Implants

One of the biggest fears is:

“Will you need to remove all my implants and start from zero?”

In many cases, the answer is no.

We can often keep the implant fixtures and replace only the parts on top (abutments, crowns, bridges).

3.1 When Implants Are Healthy but Prosthetics Are the Problem

If imaging and examination show that:

Implants are well integrated in bone (no major bone loss)

There is no active infection around them

The position and angulation are acceptable

but you still have problems with:

Aesthetics

Bite

Comfort

then the main issue is often prosthetic design, not the implants themselves.

In such cases, treatment may involve:

Changing abutments (the connectors between implant and crown)

Designing new zirconia or ceramic crowns/bridges with better shape, size and shade

Adjusting bite (occlusion) to distribute forces more evenly

Improving cleaning access so that you can maintain implant hygiene better

This kind of prosthetic revision can completely transform:

Your smile

Your comfort

Your confidence

without the trauma, cost and time of removing well-integrated implants.

4. When the Problem Is Around the Implants: Peri-Implantitis and Bone Loss

Sometimes, however, the problem is biological, not just cosmetic.

4.1 What Is Peri-Implantitis?

Peri-implantitis is:

Inflammation and infection in the gum and bone around an implant

Similar to periodontitis (gum disease) around natural teeth

Often caused by plaque accumulation, overload, or design that is difficult to clean

Signs may include:

Bleeding or pus around the implant

Bad breath or taste

Deep pockets around the implant when measured

X-ray evidence of bone loss

If this condition is ignored, the implant can eventually become loose and fail.

4.2 Can Peri-Implantitis Be Treated Without Removing the Implant?

Depending on severity, treatment options at Milim Dental Bursa include:

Non-surgical therapy

Deep cleaning around the implant

Antiseptic or antibiotic therapies

Polishing and smoothing of surfaces where possible

Surgical therapy

Lifting the gum flap to clean infected tissue

Detoxifying the implant surface with special instruments and protocols

Bone grafting around the implant in selected cases

The goal is to stop the disease, stabilise bone levels and preserve the implant if possible.

We will always be honest with you:

If we believe the implant has a reasonable chance to be saved, we will explain the plan.

If the prognosis is poor, we will recommend removal rather than repeated, unsuccessful attempts.

5. When an Implant Must Be Removed – And What Happens Next

In some situations, removal is the best option from a biological and mechanical standpoint. For example:

The implant is placed in a clearly wrong position (too labial, too lingual, too close to another tooth/implant)

There is advanced bone loss with mobility of the implant

There is a persistent infection that does not respond to treatment

The implant design makes any reasonable prosthetic solution impossible

Although it sounds scary, removing a failing implant and starting again in a controlled way can be a relief:

The source of infection and chronic discomfort is gone

You have a chance to rebuild bone and plan a healthier, more stable solution

5.1 Explantation and Site Regeneration

After removing a failing implant, we often need to:

Thoroughly clean the area of granulation tissue and infection

Perform bone grafting to fill the defect

Use membranes or regenerative materials

Allow healing for a period (often several months)

Only after the site is stable do we:

Consider placing a new implant in a better position

Or choose an alternative solution (bridge, partial prosthesis, etc.)

At Milim Dental Bursa, Dr Ali Direnç Ulaşan is particularly experienced in:

Explantation of failing implants

Reconstruction of complex defects

Advanced techniques such as sinus lifting and, where indicated, zygomatic implants in severe bone loss cases

6. Designing Your “Second Chance” Smile – Function + Aesthetics

Once the biological situation is under control and we know which implants can be used, we move to smile and bite design.

This stage is often the most exciting for patients.

6.1 Analysing Your Face, Smile and Expectations

We focus on:

How much tooth and gum is visible when you smile and talk

Lip support and profile

Tooth proportions and alignment

Your age, facial features and personal preferences (natural vs “Hollywood white”)

You may have had a previous result that looked:

Too artificial

Too long or too short

Not matching your personality

This time, the design is done with you, not just “for” you.

6.2 Digital Planning and Mock-Ups

At Milim Dental Bursa we use:

Digital smile design tools

Intraoral scanning

3D planning software

We can often create a mock-up (a temporary version of your new smile) so you can:

See the shape and length of teeth before finalising

Give feedback – “I want slightly shorter”, “I like this shape better”, etc.

This reduces the risk of aesthetic disappointment once the final restorations are placed.

7. The Role of Communication and Trust in Revision Cases

If you are unhappy with previous implants, you probably felt at some point:

Not listened to

Not fully informed about risks and alternatives

Rushed into decisions

In revision cases, good communication is as important as good surgery.

At Milim Dental in Bursa, our team led by Dr Ali Direnç Ulaşan takes extra time to:

Understand what exactly bothered you with past treatment

Explain each step of the new plan in simple language

Show X-rays, 3D images and photos so you can follow the reasoning

Discuss timelines, costs and realistic expectations

You should feel:

That your concerns are taken seriously

That no one is trying to “sell” you something

That there is a clear, structured plan to make things better

8. What You Can Expect When You Contact Milim Dental Bursa

If you decide to reach out to us about your previous implants, the typical journey looks like this:

Initial Contact

You send us photos and any existing X-rays (if you have them)

Our team reviews your case and may ask a few key questions

First Consultation (Online or In-Clinic)

We talk through your history and current complaints

We explain what additional imaging or examinations are needed

Full Assessment at Milim Dental

Clinical exam, X-rays, CBCT where indicated

Photographs, scans, bite analysis

Treatment Planning with Dr Ali Direnç Ulaşan

Clear explanation of what can be kept and what must be changed

Detailed plan for:

Treating any infection or peri-implantitis

Replacing crowns/bridges

Removing and redoing implants if absolutely necessary

Execution in Phases

We often divide treatment into logical phases to:

Control disease

Rebuild foundations

Then create your final smile

Maintenance and Long-Term Follow-Up

Regular hygiene and control visits

Bite check and adjustments if needed

Support if you live abroad (online communication and cooperation with your local dentist)

9. Key Takeaways – You Are Not Stuck with Bad Implant Work

If you are unhappy with your existing dental implants, remember:

You are not alone – many patients have gone through similar experiences.

In many cases, implants themselves can be kept, and only the prosthetics need to be redesigned.

If there is infection or bone loss, peri-implantitis can often be treated – and failing implants can be removed and replaced when necessary.

A proper revision plan requires:

Detailed diagnosis

An experienced oral & maxillofacial surgeon

A clinic with digital planning and advanced surgical/prosthetic options

At Milim Dental in Bursa, Turkey, Dr Ali Direnç Ulaşan and his team are focused on:

Repairing or replacing unsatisfactory previous implant work

Protecting your remaining bone and soft tissues

Designing a smile that truly fits your face and your life

Giving you the confidence to eat, speak and smile without fear

If you recognise yourself in this article and you are thinking:

“This is exactly my situation – I need a second opinion,”

then your next step is simple:

reach out, share your story and let us analyse your case.

A carefully planned revision with an experienced surgeon can turn a daily source of stress into a long-term source of comfort and confidence.