This retrospective analysis examined the occurrence of perforations in adjacent anatomical structures caused by dental implants, using cone-beam computed tomography (CBCT). Cone-beam computed tomography scans of dental implants were examined for signs of perforations in the relevant anatomical structures. The collected data included demographic details and implant characteristics, such as the type, length, location, diameter, mesial and distal spacing, thread exposure, and whether a radiographic guide was used. Univariate and bivariate analyses were performed to determine the frequency of these perforations and their distribution across various factors. A total of 441 implants were included, of which 14.5% showed perforations in adjacent anatomical structures. The most common perforation was the inferior alveolar canal, followed by the maxillary sinus. Nearly half of the implants (47%) caused perforation of the cortical plate. Perforations were more common in the posterior region compared to the anterior region (P = 0.03). Insufficient mesial and distal spacing was significantly more frequent when the adjacent structure was an implant rather than a tooth (P < .0001). Dental implant-related anatomical perforations are relatively common, especially in the posterior region. This study highlights the importance of avoiding such perforations and underscores the necessity of careful presurgical planning using cone-beam computed tomography and implant planning software to ensure optimal clinical outcomes.
