Objectives:Risk factors in oral implantology are defined as local or systemic conditions that increase failure rates. The purpose of this paper is to evaluate the long-term survival rate of dental implants placed in patients presenting mechanical risk factors.Materials and Methods:This retrospective study was conducted only with patients presenting at least one of the following risk factors were included: Bruxism; crown-to-implant (C/I) ratio <0.8; abutment angulation. The overall implant survival was estimated using Kaplan–Meier analyses. Risk factors for implant failure were identified using the Cox proportional hazard regression models.Results:Eighty-nine eligible patients were enrolled in this study: They were both male (n = 56, 62.92%) and female (n = 33, 37.08%), with an average age of 53.24 (23–76 years), with 227 dental implants inserted. The mean follow-up was 13.6 years (range: 10–16 years). The overall 10-year Kaplan–Meier survival estimate with associated 95% confidence intervals was 86.34% (82.8, 87.1). Bruxism was the only variable that showed a statistically significant association with implant failure (P < 0.05) and a hazard ratio of 2.9, while both Crown to-implant and abutment angulations reported lower values of failure (P > 0.05).Conclusions:Within the limitations of this study, can be concluded that data suggested an evident relationship between bruxism and dental implant failure but further studies, with a larger sample and a different design are required to assess this relationship.