Full-arch implant survival rates: what 50 years of studies show
How many implants and fixed full-arch bridges are still working after 5, 10, 15 and 20 years, according to the studies dentists cite most, and why the same treatment can produce different headline numbers.
Medically reviewed by Dt. Hüseyin Yavuz Özbek, implant surgeon · Updated October 2026In long-term studies of fixed full-arch bridges, implant survival is mostly between about 91% and 99% at 10 to 20 years, and the bridges themselves survive at similar or higher rates. A review of lower-jaw full arches found 96.86% implant survival and 97.25% bridge survival at 10 years. Adjusting for patients lost to follow-up lowers these figures by a few points, and results in the upper jaw and in people over 65 tend to be a little lower.
Two numbers, not one: implants and bridges
A full-arch bridge sits on four to six implants, sometimes more. Studies usually report two survival figures. Implant survival counts the implants still in the bone. Bridge survival, often called prosthesis survival, counts the bridges still in use. If one of six implants is lost, the bridge may carry on working, which is why the bridge figure is often the higher of the two.
Implant survivalBridge survival
Show the numbers as a table
| Item | Implant survival | Bridge survival | Source |
|---|---|---|---|
| Lower jaw review, 10 yrs (2014) | 96.86% | 97.25% | Papaspyridakos et al., 2014 |
| Bridges review, 10 yrs (2012) | 93.1% | 93.9% | Pjetursson et al., 2012 |
| Four implants, lower, ≤10 yrs | 94.8% | 99.2% | Maló et al., 2011 |
| Four implants, lower, ≤18 yrs | 93% | 98.8% | Maló et al., 2019 |
| Upper jaw, 15 yrs (2006) | 90.9% | 90.6% | Jemt et al., 2006 |
Each pair comes from one study, but the studies differ in jaw, follow-up and definitions, so compare within a pair rather than across rows. Sources in the table.
In a systematic review of 17 prospective studies of fixed lower full arches, rough-surface implants survived 98.42% at five years and 96.86% at ten; one-piece bridges survived 98.61% and 97.25% Papaspyridakos et al., 2014. The number of implants and whether teeth were fitted immediately or later made no significant difference to those rates.
The longest-running four-implant data come from the Lisbon group that developed the All-on-4 concept: bridge survival of 99.2% with up to 10 years of follow-up Maló et al., 2011 and 98.8% at 10 to 18 years, with implant survival of 93% Maló et al., 2019. All-on-4 is a Nobel Biocare trademark; we are not affiliated with any implant maker.
How the method changes the headline
Here is the uncomfortable part. A 2019 review of 18 studies found 10-year implant survival of 96.4% using the usual method. When the authors allowed for patients who had left the studies, the estimate fell to 93.2%, and to 91.5% for people aged 65 or over Howe et al., 2019. Same data, different assumptions, and a swing of up to five points.
Show the numbers as a table
| Item | Implant survival | Range | Source |
|---|---|---|---|
| Lower jaw, 20 years (2003) | 98.9% | – | Ekelund et al., 2003 |
| 10 years, standard analysis | 96.4% | 95.2–97.5% | Howe et al., 2019 |
| 10+ years, 23 studies (2015) | 94.6% | – | Moraschini et al., 2015 |
| 10 years, adjusted for drop-outs | 93.2% | 90.1–95.8% | Howe et al., 2019 |
| 10 years, patients 65 or over | 91.5% | – | Howe et al., 2019 |
| Upper jaw, 15 years (2006) | 90.9% | – | Jemt et al., 2006 |
Howe 2019 is a review of implants in general, not only full arches. Its adjusted estimate counts people who left the studies, which is usually more realistic.
Drop-outs are common in long studies. In the 18-year four-implant study, 31.6% of patients were lost to follow-up and 5.7% had died Maló et al., 2019. In a 15-year upper-jaw study, 44 of 76 patients were lost Jemt et al., 2006. Those people may have done better or worse than the ones who came back; nobody knows, which is exactly the problem.
Most long-term figures are calculated with life tables or the Kaplan-Meier method, which estimate survival when patients are followed for different lengths of time. The figure at the far end of the curve is often based on only a few people. Look for the number still being followed at that point.
Survival versus success
An implant can be present and still be a problem: sore, inflamed or losing bone. That is why researchers proposed stricter success criteria in 1986 Albrektsson et al., 1986. A later systematic review found the most common implant-level criteria were mobility, pain, a dark line on the X-ray and bone loss of more than 1.5 mm, and argued that the implant and the teeth on it should be judged together Papaspyridakos et al., 2012.
| Study | Follow-up | Implant survival | Implant success | Bridge survival |
|---|---|---|---|---|
| Maló et al., 2019, lower jaw, four implants | 10 to 18 years | 93% | 91.7% | 98.8% |
| Maló et al., 2011, lower jaw, four implants | up to 10 years | not separately reported | 94.8% (implant-related) | 99.2% |
| Jemt et al., 2006, upper jaw | 15 years | 90.9% | not reported | 90.6% |
Upper jaw, lower jaw
From the very first series, the upper jaw was harder. Of 895 implants placed with the standardised Swedish method, 81% of upper and 91% of lower implants remained stable after 5 to 9 years, and the bridges were stable in 89% of upper and 100% of lower jaws Adell et al., 1981. Upper-jaw bone is softer and the maxillary sinus takes up space. Modern rough-surface implants have narrowed the gap: a review of four-implant full arches found no significant difference between upper and lower jaws over three years Patzelt et al., 2014. For the anatomy behind this, see the upper jaw and sinus.
Zygomatic implants
When the upper jaw has too little bone, long zygomatic implants can anchor in the cheekbone instead. Their survival figures are similar to those of standard implants, at around 95% to 96% over roughly 6 to 12 years.
Show the numbers as a table
| Item | Zygomatic implant survival | Range | Source |
|---|---|---|---|
| ITI consensus, mean 6.3 years | 96.2% | 93.8–97.7% | Al-Nawas et al., 2023 |
| Review of 68 studies, 12 years | 95.21% | – | Chrcanovic et al., 2016 |
| Case series, 10 years | 95.12% | – | Aparicio et al., 2014 |
Survival is high; the main problem reported is sinusitis (2.4% in the 2016 review, 14.2% total prevalence in the 2023 consensus).
The trade-off is complications, mainly sinusitis, which we cover on the complication rates page and in cheekbone anchorage.
Where most failures happen: the first year
In a review of four-implant full arches, 74 of 4,804 implants failed, and 74% of those failures came in the first 12 months Patzelt et al., 2014. In the 15-year upper-jaw study most implants were lost at the second-stage surgery or in the first year of function Jemt et al., 2006. Early failure usually means the implant never fully fused with the bone (see how implants fuse with bone). Later losses are more often linked to peri-implantitis, which is why regular maintenance matters for decades.
What this means if you are considering treatment
- Ask how a clinic defines any success figure it quotes, and over what period. A percentage without a method is not comparable with these studies.
- Expect the bridge to need maintenance even if the implants stay healthy. Our complication data shows how often.
- Know your own risk factors: smoking, grinding and a history of gum disease matter more than age alone. See risk factors.
Common questions
How long do full-arch implants last?
There is no fixed expiry date. Studies have followed lower-jaw full arches for more than 20 years with 98.9% of implants still in place, and four-implant lower bridges for up to 18 years with 98.8% of bridges still in use. The bridge's tooth surfaces usually wear or chip before the implants fail, and those can be repaired or remade.
What is the difference between survival and success?
Survival means the implant is still in your mouth. Success means it is there and also free of pain, mobility, infection and excess bone loss. In the 18-year four-implant study, implant survival was 93% and success 91.7%.
Do upper-jaw implants fail more often?
Historically yes. In the original Swedish series, 81% of upper and 91% of lower implants remained stable after 5 to 9 years. Modern reviews often find smaller or no differences, but upper-jaw bone is softer and the sinus limits space, so planning matters more. See the upper jaw and sinus.
Does my age change the odds?
A 2019 review estimated 10-year implant survival of 91.5% for people aged 65 or over, against 93.2% overall in the same adjusted analysis. Age is one factor among many; general health, smoking and cleaning matter as much.
When do most implants fail?
Early. In a review of four-implant full arches, 74% of failures happened in the first 12 months, and zygomatic implant failures cluster in the first six months. After the first year, failures are less common and are more often linked to gum and bone inflammation.
Sources
- Papaspyridakos P, Mokti M, Chen CJ, Benic GI, Gallucci GO, Chronopoulos V. Implant and prosthodontic survival rates with implant fixed complete dental prostheses in the edentulous mandible after at least 5 years: a systematic review. Clin Implant Dent Relat Res 2014. PMID 23311617
- Pjetursson BE, Thoma D, Jung R, Zwahlen M, Zembic A. A systematic review of the survival and complication rates of implant-supported fixed dental prostheses (FDPs) after a mean observation period of at least 5 years. Clin Oral Implants Res 2012. PMID 23062125
- Malo P, de Araújo Nobre M, Lopes A, Moss SM, Molina GJ. A longitudinal study of the survival of All-on-4 implants in the mandible with up to 10 years of follow-up. J Am Dent Assoc 2011. PMID 21357865
- Maló P, de Araújo Nobre M, Lopes A, Ferro A, Botto J. The All-on-4 treatment concept for the rehabilitation of the completely edentulous mandible: A longitudinal study with 10 to 18 years of follow-up. Clin Implant Dent Relat Res 2019. PMID 30924309
- Jemt T, Johansson J. Implant treatment in the edentulous maxillae: a 15-year follow-up study on 76 consecutive patients provided with fixed prostheses. Clin Implant Dent Relat Res 2006. PMID 16774591
- Ekelund JA, Lindquist LW, Carlsson GE, Jemt T. Implant treatment in the edentulous mandible: a prospective study on Brånemark system implants over more than 20 years. Int J Prosthodont 2003. PMID 14714838
- Howe MS, Keys W, Richards D. Long-term (10-year) dental implant survival: A systematic review and sensitivity meta-analysis. J Dent 2019. PMID 30904559
- Moraschini V, Poubel LA, Ferreira VF, Barboza Edos S. Evaluation of survival and success rates of dental implants reported in longitudinal studies with a follow-up period of at least 10 years: a systematic review. Int J Oral Maxillofac Surg 2015. PMID 25467739
- Patzelt SB, Bahat O, Reynolds MA, Strub JR. The all-on-four treatment concept: a systematic review. Clin Implant Dent Relat Res 2014. PMID 23560986
- Adell R, Lekholm U, Rockler B, Brånemark PI. A 15-year study of osseointegrated implants in the treatment of the edentulous jaw. Int J Oral Surg 1981. PMID 6809663
- Papaspyridakos P, Chen CJ, Singh M, Weber HP, Gallucci GO. Success criteria in implant dentistry: a systematic review. J Dent Res 2012. PMID 22157097
- Chrcanovic BR, Albrektsson T, Wennerberg A. Survival and Complications of Zygomatic Implants: An Updated Systematic Review. J Oral Maxillofac Surg 2016. PMID 27422530
- Al-Nawas B, Aghaloo T, Aparicio C, et al. ITI consensus report on zygomatic implants: indications, evaluation of surgical techniques and long-term treatment outcomes. Int J Implant Dent 2023. PMID 37698775
- Aparicio C, Manresa C, Francisco K, et al. The long-term use of zygomatic implants: a 10-year clinical and radiographic report. Clin Implant Dent Relat Res 2014. PMID 23078128
Checked October 2026. Where we give our own view as a clinic, we say so.
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