Purpose: Immediate replacement of a new implant for a failed implant has the benefit of reducing treatment time and increasing patient satisfaction. Limited studies have reported the outcome of implants placed in previously failed sites. It has been proposed that porous tantalum trabecular implants (TM implants) may offer superior integration due to their structure and may be beneficial in situations that normally present a clinical challenge. The purpose of this pilot study was to analyze dental implant survival in a series where failed implants were immediately replaced by TM implants. Materials and Methods: This pilot study assessed 16 implants in 14 patients where failed implants were immediately replaced by TM implants. All clinical procedures were performed by the same board-certified periodontist in a private practice setting. The implants were restored 8 to 10 weeks postoperatively with stock contour abutments and cemented crowns. Patients were recalled yearly for radiographs and clinical assessment of probing depth, bleeding on probing, and integration status. Data were collected on patient demographics, smoking status, periodontal health status, implant site and size, and the use of membranes and/or grafts. Descriptive statistics were used to describe the demographics of the study population and to calculate overall implant survival proportions. Results: The mean age at time of first implant placement was 54.4 years, with a range of 41 to 74 years. Distribution by sex was evenly split at 50% men and 50% women. The majority of patients were smokers (68.8%), and 75% of the patients had a history of moderate or severe periodontal disease. For the replacement TM implants, most were a larger size than the original implant, 6 × 10 vs 4.8 × 10. Sixteen implants were immediately placed into failed implant sites, and 15 had a successful outcome and continue to maintain function at 5 years post-implantation. Radiographs of the TM implant site showed excellent boneto- implant contact, and the patients did not show clinical signs or symptoms of pain, mobility, infection, or tenderness. Conclusion: Although the limited sample size limits comparisons to larger studies, this initial finding suggests that TM implants may be suitable for immediate placement into failed implant sites. Keywords: replacement implant, tantalum, trabecular implant