The goal of this observational study is to evaluate the effects of proton pump inhibitors (PPIs) on the surrounding bone and the survival of dental implants. The main questions it aims to answer are:

Does PPI use affect the survival rate of dental implants? Does PPI use influence crestal bone loss and fractal dimension (FD) of the surrounding bone?

Inclusion Criteria:

• Being over 18 years old,
• Having a history of PPI use for more than six months,
• Having at least one bone-level and axially placed dental implant in the maxilla or mandible,
• Having a minimum of one year elapsed since the prosthetic restoration following dental implant placement,
• Having undergone routine clinical follow-ups and radiological evaluations with periapical radiographs taken using the parallel cone technique after dental implant placement.

Exclusion Criteria:

• Individuals with a history of PPI use for less than six months,
• Individuals with periapical radiographs of low image quality or with artifacts,
• Individuals for whom the regions selected for fractal analysis on periapical radiographs are not appropriately sized,
• Individuals who have not undergone routine clinical and radiographic follow-ups.

The study was conducted with patients who had a history of PPI use for more than six months and systemically healthy individuals who had undergone regular clinical and radiological follow-ups after dental implant placement at the Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Kocaeli University.