CRUCIAL FACTORS INVOLVED IN IMPLANT FAILURE AND PERI‐IMPLANT PATHOLOGY IN SYSTEMICALLY COMPROMISED PATIENTS

Background: Systemically compromised patients exhibit elevated risks of dental implant failure and peri-implant pathology due to impaired healing and immune responses. Identifying modifiable risk factors is critical for optimizing clinical outcomes. Objective: To determine crucial factors associated with implant failure and peri-implant pathology in systemically compromised patients. Methods: A retrospective cohort study was conducted with 300 systemically compromised patients (512 implants) followed for 3.5 ± 1.2 years. Data included systemic conditions (diabetes, osteoporosis, immunosuppression), implant characteristics, smoking status, oral hygiene indices, and clinical outcomes. Logistic regression identified risk factors. Key Findings: Implant failure occurred in 12.7% of cases. Uncontrolled diabetes (HbA1c >7%) increased failure risk (OR = 3.5, 95% CI: 2.1–5.8, p < 0.001), as did smoking (OR = 2.8, 95% CI: 1.5–5.2, *p* = 0.002) and poor oral hygiene (plaque index >30%; OR = 2.1, 95% CI: 1.2–3.7, p = 0.01). Peri-implantitis affected 18.3% of implants, strongly associated with diabetes (p = 0.003) and smoking (p = 0.005). Conclusion: Uncontrolled diabetes, smoking, and poor oral hygiene are pivotal risk factors. Strict glycemic control, smoking cessation, and enhanced hygiene protocols are essential for implant success in this population.