When implants go wrong: peri-implantitis

Updated: Sep 11, 2020

Many people think implants will last forever, but peri-implantitis has been shown to cause implant failure in up to 20% of patients. Don't worry, implants are still probably the best solution for a missing tooth. Material continue to advance and create beautiful aesthetic results, but knowing potential complications can help you prepare and reduce chance of failure.

Smoking, implants in the top arch (maxillary arch) and diabetes are common risk factors. Smoking decreases the vascularization and oxygenation of the bone, making it harder for the implant to osseo-integrate and heal.


The maxillary arch has complex anatomy, which can lead to implant infection. Implants in the back of the maxilla are at highest risk of failure.

Diabetic patients with an Hba1c above 8 are usually not good candidates for implants. Patients on antibiotics, chlorhexidine or existing periodontal issues are also at risk and need to get their oral health under control before proceeding to implants.

Medications such as SSRI’s, antiresorptive, proton pump inhibitors, head and neck irradiation and certain cancer medications can also increase risk of developing peri-implantitis.

Patient with a history of bruxism will likely need mouthguard or have their bite issues sorted. The dentist may opt to make a nightguard for such a patient as well. Over stress can lead to crestal bone loss and infection because it causes rotational wear on the sulcus.


An unfavorable crown contour can lead to plaque buildup, creating a great breeding ground for periodontal bacteria. Low density bone can also put someone at risk of developing peri-implantitis.

Although this is uncommon, it’s something to consider. If you have any of these risk factors, talk to your dentist and doctor on how to improve chances for a successful implant procedure.

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