Objective The aim of this study was to document cofactors associated with peri-implant disease progression.

Material and methods The clinical charts and radiographs of patients who received dental implant at University of Pennsylvania or outside office were reviewed for maximum 13 years. Cofactors were divided two categories in this study. Patient related factors included age, active periodontitis patient, keratinized tissue around implant, smoking, diabetes, and more than 3 co morbidities. Implant related factors included diameter, length, one or two stage surgery, screw or cement retained restoration, and restoration types.

Results This study involved 1004 implants from 308 patients (mean age 76.6 ± 10.9 years). Implant survival rate was 94.2%, with 5.8% failures. At the patient level, 87.7% had surviving implants, and 12.3% had at least one failure. Active periodontitis, smoking, and having more than three comorbidities were associated with peri-implant disease.

Conclusion From this retrospective study, active periodontitis patient, smoking, and more than three co morbidities might cofactors associated with peri-implant disease progression.