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Risk Factors Associated With Early Implant Failure

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Risk Factors Associated With Early Implant Failure

Alan B Carr, DMD, MS - Noura Arwani, DDS - Christine M. Lohse, MS - Ricardo Vidal Gonzalez, DDS, MS - Olivia M. Muller, DDS - Thomas J. Salinas, DDS

Dental Specialties Mayo Clinic, Rochester, MN


Implant failure is a multifactorial complication with higher incidence within the first year of implant placement. Identifying risk factors, which influence lack of osseointegration and early implant loss, is essential to provide evidence based discussion with patients regarding their future risk of encountering failure.


Data were abstracted from prospectively maintained database of all patients with implants between January 1, 2000 and December 31, 2014 at the Department of Dental Specialties at Mayo Clinic in Rochester, Minnesota.

Associations of candidate predictors with early implant failure, defined as failure within the first year of implant placement, were evaluated using Cox proportional hazards regression models and summarized with hazard ratios and 95% confidence intervals (CIs). Two-sided p-values <0.05 were considered statistically significant.


Among the 8,540 implants under study, 362 (4.2%) failed within the first year of placement at a mean of 129 (SD 96) days following placement (range 2 to 360).

Age, sex, anatomic location, designated implant geometry characteristics, immediate placement, and reasons for extraction were not identified as increasing risk for failure.

Significant association with early implant failure was seen with the surgical manipulations ‘bone augmentation only’ (56 failures out of 940 implants), ‘alveoloplasty  only’ 'protective' (8 failures out of 285 implants), and ‘xenogenic material’ (11 failures out of 129 implants).

Surgical complications increased the risk for implant failure. This included specific complications (see Table 2).

The risk for implant failure in a patient with a history of periodontal disease is less clear. The data suggests periodontal disease history increases the risk for surgical complications (HR=1.84, P=0.025), but analysis of a periodontal disease impact on failure does not reveal significance.


Bone augmentation before implant placement, xenogenic augmentation material, and surgical complication were found to be associated with early implant failure.

These will be considered for follow-up analysis and quality improvement application.


1. Jemt T, Olsson M, Franke Stenport V. Incidence of First Implant Failure: A Retroprospective Study of 27 Years of Implant Operations at One Specialist Clinic. Clin Implant Dent Relat Res. 2015;17 Suppl 2:e501-10.

2. Carr AB, Revuru VS, Lohse CM. Association of Systemic Conditions with Dental Implant Failures in 6,384 Patients During a 31-Year Follow-up Period. Int J Oral Maxillofac Implants. 2017;32(5):1153-61.

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