surface (through etching, anodic oxidation or various-media blasting) to increase the surface area and osseointegration potential of the implant. If C.P. titanium or a titanium alloy has more than 85% titanium content, it will form a titanium-biocompatible titanium oxide surface layer or veneer that encloses the other metals, preventing them from contacting the bone. Ceramic (zirconia-based) implants exist in one-piece (combining the screw and the abutment) or two-piece systems - the abutment being either cemented or screwed - and might lower the risk for peri‐implant diseases, but long-term data on success rates is missing. Technique Planning General considerations Planning for dental implants focuses on the general health condition of the patient, the local health condition of the mucous membranes and the jaws and the shape, size, and position of the bones of the jaws, adjacent and opposing teeth. There are few health conditions that absolutely preclude placing implants although there are certain conditions that can increase the risk of failure. Those with poor oral hygiene, heavy smokers and diabetics are all at greater risk for a variant of gum disease that affects implants called peri-implantitis, increasing the chance of long-term failures. Long-term steroid use, osteoporosis and other diseases that affect the bones can increase the risk of early failure of implants. It has been suggested that radiotherapy can negatively affect the survival of implants. Nevertheless, a systemic study published in 2016 concluded that dental implants installed in the irradiated area of an oral cavity may have a high survival rate, provided that the patient maintains oral hygiene measures and regular follow ups to prevent complications. Biomechanical considerations The long-term success of implants is determined, in part, by the forces they have to support. As implants have no periodontal ligament, there is no sensation of pressure when biting so the forces created are higher. To offset this, the location of implants must distribute forces evenly across the prosthetics they support. Concentrated forces can result in fracture of the bridgework, implant components, or loss of bone adjacent the implant. The ultimate location of implants is based on both biologic (bone type, vital structures, health) and mechanical factors. Implants placed in thicker, stronger bone like that found in the front part of the bottom jaw have lower failure rates than implants placed in lower density bone, such as the back part of the upper jaw. People who grind their teeth also increase the