Based on published demographic data, the median age of the world population constantly increases [1]. This has led to an increase in the number of dental implants inserted in senior individuals with local and systemic risk factors [2]. Nevertheless, despite numerous studies having been conducted on this topic, the results remain controversial, almost 50 years after the first dental implant placement, and there remains no consensus regarding the factors influencing success rates in implant dentistry.

In the presence of diabetes, there is a delayed wound healing [3], especially in patients with poor glycemic control [4]. In both experimental [5] and clinical [6] studies, a reduced osseointegration was noticed, which may have led to an increased risk of failure. Other studies [7] have alluded to the impact of radiation exposure and its side effects like xerostomia and mucositis, which may have also increased the risk for implant failure. It is believed that the irradiated hypocellular, hypovascular, and hypoxic tissues are the main cause of failures in dental implant osseointegration. Moreover, in patients who are undergoing or who earlier received treatment with cortisone or chemotherapy, implant placement might lead to loss of osseointegration [8].

In addition to systemic factors, there are also several local factors that may affect implant survival. Any factor or condition that may potentially lead to loss of primary stability should be considered as a risk for implant survival and must be detected and treated early. Such factors are the presence of severe, untreated periodontitis [9, 10], prior endodontic [11] or implant treatment at the placement site [12], previous trauma [13], alveolar clefts [14], and any other factors causing large bony defects.

Despite the existing risk factors, dental implants continue to gain popularity, and in recent years, there is an increasing demand for immediate loading and provisionalization combined with high esthetic expectations. There are several techniques and systems developed, and it can be considered that implant survival rates, although they are directly correlated to variable biological factors, approach those of traditional techniques [15]. The overall treatment time is reduced, which generally increases patient satisfaction [16].