Comparison of Implant Survival in Sites with Previous Endodontic Failure Versus Periodontally Compromised Teeth

Objective: This study aimed to compare the survival and clinical performance of dental implants placed in sites with a history of endodontic failure versus those affected by periodontal disease. Methods: A total of 70 patients were enrolled and divided into two equal groups: Group A (endodontic failure, n = 35) and Group B (periodontal disease, n = 35). All implants were placed using a standardized two-stage surgical protocol and followed for 24 months. Primary outcomes included implant survival, marginal bone loss, probing depth, and incidence of peri-implantitis. Secondary outcomes were patient satisfaction and postoperative infection rates. Statistical analysis was performed using Kaplan–Meier survival estimates, t-tests, and chi-square analysis, with p < 0.05 considered significant. Results: At 24 months, implant survival was higher in Group A (91.4%) than Group B (82.9%). Marginal bone loss was significantly lower in the endodontic group (0.92 ± 0.35 mm) compared with the periodontal group (1.35 ± 0.45 mm). The incidence of peri-implantitis was 11.4% in Group A and 22.9% in Group B, while mean probing depths were 3.1 ± 0.8 mm and 3.9 ± 0.9 mm, respectively. Patient satisfaction scores were high in both groups but slightly favored the endodontic group. Postoperative infections were more frequent in periodontally compromised sites. Conclusion: Implants placed in sites with a history of endodontic failure demonstrated favorable outcomes comparable to healthy sites, whereas those placed in periodontally compromised patients showed reduced survival and increased biological complications. Periodontal history remains a significant risk factor requiring strict maintenance protocols.