Dental Implant Risk Factors

Dental implant risk factors

PEARL Network risk factors JADA 2014 July

  • History severe periodontitis
  • Preexisting inflammation in site (endo lesion or perio lesion)
  • Type IV bone
  • Immediate vs delayed
  • Anterior vs posterior

Risk Factors (highlight those linked to “cluster phenomenon”)

    • poor bone quality or bone bone support
    • untreated chronic periodontitis
    • active infections
    • systemic diseases (diabetes = 5-10% decrease success rate but not sure if that is untreated? Lit review says no difference Cheng 2015 JADA July)
    • smoking (heavy=seen 10-15 called heavy) 2x failure rate 4x in augmented bone
    • unresolved caries or infection
    • advanced age (although there is research showing older age decreases risk as well Malm 2018 J Pros)
    • short and/or small implants
    • eccentric occlusal loading
    • specific genotypes Agrawal JPD 2023
    • inadequate number implants
    • parafunctional habits
    • bisphosphonate discontinue oral 3 months before surgery if  >3 years
    • hx radiation treatment (8 years post radiation is even worse not sure why?)
    • Antidepressants (doesn’t breakdown into types) Chrcanovic 2016 J Dent Res
    • SSRI – There is a 5% increase in failure rate according to Shariff JOI 2023 meta-analysis. Wu 2014 J Dent Res  Altay JOI 2018  Chrcanovic 2017 IJOMS They inhibit bone regeneration. Hezaimi JOE 2023 SSRI increases bruxism so that side effect may have an impact as well. Garrett 2018
    • Sertaline Zoloft 60% greater risk of failure and multiple SSRI issue as well. Carr J Prostho 2019
    • Proton pump inhibitors cause about a 5% increase in failure rate Chappuis 2018 COIR
    • Interesting that Carr JP 2019 found no correlation of failures to any medication
    • Do patients with penicillin allergy have higher rates or is it the clindamycin that is causing failures. 24% failure rate leads me to believe it must be clindamycin. Salomó-Coll JOMI 2018
SSRI dental implant failure
Failure at one year. I believe SSRI played a contributing role.
SSRI dental implant failure
Implant at time of placement

Anterior dental implant esthetic risk factors

implant esthetic risk profile
Implant esthetic risk profile

Dental Implant Risk Factors

Failure rates of dental implants

Studies are typically showing rates from 85-95%. There is some variance in what survival and success definitions are in the literature. Lazaro-Abdulkarim JOMI 22 has a failure rate in a university setting of 5%.

Reasons for dental implant failure

Risk factors include – untreated periodontal disease, systemic disease, smoking, unresolved caries or infection, advanced age, short/small implants, inadequate number of supporting implants, parafuncitonal habits

Options Remove implant, debride site, clean CHX and/or NaCl .9% Baxter Health, graft

Cluster failure – is when multiple implants fail on the same individual risk factors of this condition are lack of bone support or quality, heavy smoker, short implants, existing periodontitis and bruxism

List of causes of dental implant failure


Dental implant bone loss risk factors

What are the patient risk factors for bone loss around dental implants from Ting 2017 Implant Dentistry systemic review?

  • Periodontal disease is a major risk factor, with aggressive periodontitis being worse than chronic.
  • Less bone loss in grafted sockets but more in ridge augmentation sites.
  • More bone loss in smokers and in men.
  • Smokers have more in the maxilla than the mandible.