Foundations for Long-Term Implant Success

Patients receiving implant-borne prostheses require functional, esthetic, and long-term success. The importance of this review is to document with literature-based evidence, 6 core determinants that are associated with long-term success, and minimize the risks for implant failure. The objective is to provide surgeons with a list to clinically achieve that can be implemented to provide long-term functional and esthetic results.

Pubmed.gov was the information source. Years reviewed included 1990 to 2025. Inclusion criteria included only articles in journals referenced in pubmed.gov. The reports excluded were case reports and articles without a statistical analysis to generate meaningful conclusions. Data collected included outcomes of the study including statistical significance.

The search identified articles for review using terms which included patient factors for dental implant success (n = 162), gingival thickness and dental implant success (n = 110), bone thickness and dental implant success (n = 382), alveolar onlay graft resorption over time (n = 120), alveolar onlay xenografts (n = 23), implant position and dental implant success (n = 826), and crown contour and dental implant success (n = 65). From this search, 67 articles were collated that satisfied the inclusion criteria. Literature evidence supports the need to 1) identify patient-specific comorbidities that increase the risk for failure; 2) to establish thick gingiva in the implant locations; 3) establish at least 2 mm of hard tissue facial to the implant; 4) utilize grafts that will not significantly resorb over time; 5) place the implant in the correct position to optimize soft tissue health; and 6) prepare the restoration avoiding overcontouring the crowns, using an ideal emergence and embrasures for long-term gingival health and maintenance.

If the clinicians involved with the implant therapy follow the above mentioned foundations, long-term success will be optimized for the patient with limited peri-implant disease.