FULL-ARCH IMPLANT-SUPPORTED PROSTHESES: COMPLICATIONS, RISK DETERMINANTS, AND MAINTENANCE BURDEN

Abstract

Full-arch implant-supported prostheses are widely used for the rehabilitation of complete edentulism and usually demonstrate high implant and prosthesis survival. However, long-term success should not be judged by survival alone. A restoration may remain in function while being affected by peri-implant disease, marginal bone loss, repeated prosthetic repair, and a substantial need for supportive care. This thesis summarizes current evidence on biologic and technical complications of full-arch implant-supported prostheses, examines the main risk determinants, and highlights maintenance burden as a clinically relevant outcome. The paper is based on a structured critical review of publications indexed in PubMed/MEDLINE, Scopus, and Web of Science. The available evidence indicates that peri-implant mucositis, peri-implantitis, late implant loss, wear or fracture of restorative materials, screw-related complications, and repeated maintenance procedures remain central long-term concerns. Current comparisons of four- and six-implant protocols generally show similar survival and biologic outcomes, whereas differences are more often related to biomechanics, restorative complexity, and service burden. Therefore, treatment planning should incorporate not only anatomy and initial stability, but also hygiene access, patient adherence, prosthetic material, and the projected maintenance load.