Aim: The aim of this retrospective study was to determine the implant failure rate and associated factors in the academic setting by using electronic health records (Axium) and hard copies of patients who received dental implants at in Penn Dental Medicine (PDM) and at Penn Dental Faculty Ppractices (PDFP) ofat the University of Pennsylvania from 06/01/2016 to 08/31/201920. In addition, evaluation of electronic health records and hard copies were reviewed for patients who had implants removed due to bone loss or lack of osseointegration atin PDM and Faculty practicesPDFP of the University of Pennsylvania from 06/01/2016 to 02/29/2020. Secondary objective was to investigate the co-contributing factors for implant failure at the patient level. Method and Material: Electronic health records and hard copies of patients who had implants placed and removed due to bone loss or lack of osseointegration atin PDM and Faculty practicesPDFP of the University of Pennsylvania from 06/01/2016 to 02/29/2020 were analyzed. Results: Data was evaluated at patient count and implant count for this retrospective study. 1609 patients received implants. 883 patients had implant placement at PDM and 726 patients had implant placement at PDFP. Of the total patients, 3180 implants were placed during the study period. 2162 implants were placed at PDM and 1018 implants were placed at PDFP. The total patient failure rate was 4.97% and the failure rate was of 6.0% and 3.7% for PDM and PDFP, respectively. The total implant failure rate was 3.49% and the implant failure rate was 3.7% and 3% for PDM and PDFP, respectively. Based on the chi-square test results, patients with bisphosphonate IV+PO (12%, P-value=0.004) were significantly overrepresented in the failure group. In contrast, patients with no bisphosphonate use (4.60%, P-value=0.004) were significantly underrepresented in the failure group. No overrepresentation (or underrepresentation) of patients with different gender, different age group, diabetes mellitus, history of periodontal disease, current smoking status, penicillin allergy, and recall were noted amongst failures. Based on the chi-square test, implants for bisphosphonate IV variable (11.5%, P-value=0.025) were significantly overrepresented in the failure group. In contrast, implants for no bisphosphonate use (3.20%, P-value<0.001) were significantly underrepresented in the failure group. No overrepresentation (or underrepresentation) of implants for different gender, different age group, diabetes mellitus, history of periodontal disease, current smoking status, penicillin allergy, and recall was noted amongst failures. Based on the multivariate conditional logistic regression, estimated odds of implant failure in participants with multiple implants were about three times than the participants with single implant (Adj OR=2.99, P-value=0.002); estimated odds of implant failure for bisphosphonate use of IV and PO was about four times that of the participants with no bisphosphonate use (Adj. OR=4.09, P-value=0.003). Diabetes and history of failed implants did not show any significant association with implant failure (with P-values>0.05). Conclusion: This study concluded that bisphosphonate use and patients with multiple implants were shown to have a significant contribution to implant failure. There was no difference in the failure rate of patients with different gender, different age group, diabetes mellitus, history of periodontal disease, current smoking status, penicillin allergy, and recallamongst failures. It is important to note that due to limitations and the retrospective nature of this study, only the co-contributing factors were evaluated and not the etiology of the implant failure. To further investigate the etiology, randomized clinical trial should be conducted.