This prospective analysis identifies factors associated with endosseous implant removal as well as factors associated with implant morbidity resulting in nonscheduled patient visits. Treatment of the latter conditions is discussed. The most important factors identified for implant success were surgery without compromise in technique, placing implants into sound bone, avoiding thin bone or implant dehiscence at the time of implant placement, avoiding premature implant exposure during the healing period, establishing a balanced restoration, and insuring appropriate follow-up hygiene care. In the posterior mandible, the presence of keratinized gingiva was strongly correlated with optimal soft- and hard-tissue health.