Risk Factors for Early Dental Implant Failure and Corresponding Clinical Management Strategies: A Systematic Review

Early dental implant failure (EIF) is a multifactorial phenomenon. This systematic review aims to identify the key risk factors for EIF and to propose evidence-based clinical management strategies. The results indicate that patient-related factors (e.g., diabetes, smoking) are associated with a 2- to 3-fold increase in the risk of early failure. Local anatomical factors (such as placement in the anterior maxilla or the use of short implants) may lead to variations in failure rates ranging from 18% to 40%. Surgical procedural errors (e.g., bone temperature exceeding 47°C during osteotomy) can raise the failure risk by approximately 50%, whereas prophylactic antibiotic use may reduce it by about 60%. Based on current evidence, we propose a comprehensive four-dimensional preventive framework, which includes:(1) strict patient selection criteria (e.g., requiring HbA1c <7% and smoking cessation for at least 4 weeks preoperatively); (2) precise anatomical evaluation (e.g., utilizing cone-beam computed tomography for bone density analysis); (3) standardized surgical protocols (including limiting the number of implants placed per session and carefully controlling bone temperature during osteotomy); and (4) individualized healing protocols (prioritizing submerged healing for high-risk cases). Clinical evidence suggests that the implementation of this comprehensive management strategy can achieve an early implant survival rate exceeding 97%, thereby laying a solid foundation for long-term restorative success. This study provides clinicians with a systematic decision-making framework to reduce early implant failure rates, emphasizing the necessity of thorough preoperative assessment and enhanced diagnostic skills for improving implant outcomes.