Background and Purpose The purpose of this study was to assess the occurrence and prognosis of dental implant proximity or direct contact with the adjacent tooth and to evaluate the symptoms and complications in both the implant and the adjacent tooth. We then elaborate on treatment modalities and discuss the prevention of this phenomenon. Materials and Methods This retrospective study was conducted based on the dental clinical and radiographic records of 43 patients with implant‐tooth proximity of <1.0 mm or direct implant‐tooth contact. Multivariate Bayesian logistic regression was performed to examine the influence of individual variables on correcting major clinical variables. Results In the multivariate regression analysis, the rate of occurrence of tooth symptom decreased by about 95% with every increase of 1.0 mm distance between implant and tooth (odds ratio [OR] = 0.1, 95% confidence interval [CI]: 0.004–0.680, p = 0.024). In the case of implant‐tooth root proximity in the anterior area, the OR of peri‐implantitis occurrence was 30.4‐fold greater than in posterior sites (OR = 30.4, 95% CI: 1.189–785.914, p = 0.040). Conclusion Implant‐tooth root proximity or direct implant‐tooth contact is an iatrogenic factor that causes various complications, including devitalization of the adjacent tooth and peri‐implantitis. Proactive prevention with surgical stents and intra‐operative periapical radiographs is needed. If proximity or contact is found during surgery, repositioning of the fixture to the correct location is recommended in order to maintain peri‐implant health and prevent complications.

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