Biomechanical failures in implant-supported prostheses: causes, prevention, and clinical management

Abstract

Biomechanical failures in implant-supported prostheses represent one of the main causes of functional and aesthetic failure in implant-supported rehabilitations, even with the technological advances and improvements in dental materials. This study aimed to critically analyze the causes, preventive strategies, and clinical management of biomechanical failures in implant-supported prostheses through an integrative literature review based on the methodological framework proposed by Whittemore and Knafl (2005). The search was conducted in PubMed, Scopus, Web of Science, and SciELO databases, covering publications between 2010 and 2025. Studies addressing mechanical and prosthetic complications related to dental implants, focusing on etiology, prevention, and clinical management, were included. The analysis showed that the main factors associated with failures include occlusal overload, inadequate torque, implant misalignment, lack of structural passivity, and improper material selection. Preventive strategies such as three-dimensional planning, screw torque control and retightening, and regular maintenance proved effective in reducing complications. Clinical management should be individualized, involving early diagnosis, controlled retightening, replacement of damaged components, and continuous occlusal reassessment. It is concluded that the biomechanical success of implant-supported prostheses depends on meticulous planning, interdisciplinary collaboration, and adherence to maintenance protocols, integrating engineering, occlusal, and material science principles to ensure long-term durability and clinical predictability.