Prosthetic Guidelines to Prevent Implant Fracture and Peri‐Implantitis: A Consensus Statement from the Osstem Implant Community

Dental implants have become a cornerstone in restorative dentistry, offering effective solutions for tooth loss. However, their long-term success is often challenged by both biological and technical complications that can affect implant longevity and patient satisfaction. Biological complications, such as peri-implantitis, are characterized by inflammation and bone loss around the implant, leading to implant failure if left unmanaged. Peri-implant bone loss greater than 2 mm occurs in a significant portion of cases, with rates of 20.1% after five years and 40.3% after ten years. Technical complications, including screw fractures and prosthetic issues like chipping, also contribute to implant failure. The etiology of implant fractures is multifactorial, with biomechanical overload, material fatigue, implant design, and patient-related factors such as bruxism playing significant roles. Advances in implant materials and surface modifications aim to reduce these risks, yet cases of implant fractures continue to be reported, underlining the need for improved diagnostic, preventive, and management strategies. Peri-implant diseases, including peri-implantitis, are also on the rise, with patient-, surgical-, and prosthetic-related factors contributing to their development. To address these challenges, this narrative review synthesizes current evidence on the risk factors, prevention strategies, and management approaches for both biological and technical complications associated with dental implants. Through a systematic approach, a consensus was reached during the Osstem Global Consensus Meeting, providing updated guidelines to support clinicians in enhancing the long-term success of dental implants. These guidelines emphasize the prevention of mechanical failures, peri-implant diseases, and the importance of early detection and intervention.