Prosthetic failures in dental implant therapy

Introduction
In cases of missing teeth, there are two options for their replacement. fixed or by removable implant-
supported prostheses. The decision is made based on anatomic, esthetic, and economic factors, and
most importantly the wishes of the patient. The choice of prostheses influences the success rate of the
treatment very much. In partially edentulous spaces, the decision is straight forward and the best option
here is fixed implant prostheses. However, for completely edentulous spaces, the decision might be
more complex because facial aesthetics and complexity of the surgical intervention must be considered.
Complications that occur may be technical complications which are relevant to laboratory-fabricated
parts such as fracture and chipping of the veneering materials, whereas mechanical complications
represent complications relevant to the prefabricated parts, such as implant fracture or abutment
failures.
Discussion
Most common complications were discussed in this journal. First, complications that occur in single
implant-retained crowns. The first one was Fracture or loosening of retaining abutment/ prosthetic
screws. Screw fractures are rare, but screw loosening is the most common complication with single
implant-retained crowns which is influenced by crown design (screw-retainable or cementable) and the
implant abutment connections (external or internal). To avoid this, straight implants should be used
instead of angulation-correcting implants, the number of retaining screws should be limited to one,
manufacturer-recommended torque values should be adhered to and implants with internal implant-
abutment connections are preferred to external connection systems. The second complication is loss of
crown retention as a result of de-cementation is the second most frequent complication with implant
single crowns. The third complication is Chipping or fracture of the veneering material. This one cannot
be avoided because the oral cavity is a very challenging environment for dental materials. Humidity,
chemical attacks like acidic food or drinks, and changing temperatures lead to accelerated aging of
ceramics which in turn increases the risk of fracture or chipping. This is also influenced by occlusion and
Inherent defects and pores within the ceramic resulting from the manual veneering procedures. The
fourth is Fractures of ceramic abutments and esthetic complications where the peri implant mucosa and
the level of the implant restoration may be discolored.
For Multiple-unit implant-fixed dental prostheses; the most common complications include chipping of
veneering ceramic, fracture of zirconia frameworks, and screw loosening. For implant-retained
overdentures; risk factors for complications either technical or mechanical include attachment type,
number of supporting implants, whether the implants are going to be placed on the maxilla or mandible,
available prosthesis space and opposing dentition, and finally; the prosthetic material.

Conclusion
In conclusion, a lot has to be considered while creating a treatment plan that involves implants. Because
the smallest thing neglected can lead to failure of the whole treatment. So, a comprehensive
pretreatment diagnostic work-up, including defining the prosthetic goalis crucial. Needless to say that
selection of the ideal type of prosthesis, including the respective implant components and materials, is
important for the clinical long-term success of the reconstruction.