[Kwan-Tae Noh Vice Chair, Prosthodontics Division (2026 Osstem Implant Community (OIC) Global Consensus: Prosthetic Guidelines for the Prevention of Implant Complications and the Maintenance of Peri-Implant Tissue Stability)]

Recently, the Osstem Implant Community (OIC) organized a Global Consensus Meeting involving implant prosthodontic experts from both Korea and abroad. Through this meeting, consensus papers were published summarizing prosthetic guidelines for preventing implant complications and discussing the influence of implant prosthetic design and abutment selection on peri-implant tissue stability.

1. Introduction
The long-term success of implant therapy depends not only on osseointegration but also significantly on prosthetic design and maintenance. Recent studies have shown that prosthetic factors—including occlusal loading, prosthetic contour, abutment design, and retention type—play important roles in the development of implant complications such as implant fracture and peri-implantitis.
In addition, peri-implant diseases and mechanical complications are now understood to arise not from a single cause but from the interaction of multiple factors, including patient-related, surgical, and prosthetic factors. Therefore, systematic clinical guidelines for prosthetic planning and design are required to minimize implant-related complications.

2. Methods
At the Osstem Global Consensus Meeting, a panel of prosthodontic experts conducted narrative and scoping reviews based on the available literature. Through structured discussions and questionnaires addressing key prosthetic-related clinical questions, a consensus was reached.
The analysis focused on prosthetic factors in implant-supported prostheses, including abutment design, emergence profile, prosthetic materials, retention type, implant position, and occlusal management.

3. Results

Based on the literature review and expert consensus, the following prosthetic factors were identified as important determinants of peri-implant tissue stability and the prevention of implant complications.

- Emergence profile: A concave profile is favorable for soft-tissue stability and plaque control.
- Emergence angle: Angles below approximately 30° are associated with a reduced risk of peri-implant inflammation and marginal bone loss.
- Retention type: Screw-retained prostheses present a lower risk of peri-implantitis compared with cement-retained restorations.
- Abutment material: Titanium provides superior mechanical stability in posterior regions, whereas zirconia offers improved esthetic outcomes in anterior areas.
- Occlusal management: Excessive occlusal loading is a major risk factor for implant fracture and peri-implant bone loss; therefore, regular occlusal adjustment and monitoring are recommended.
- Implant–abutment interface management: Platform switching and the one-abutment–one-time protocol have been proposed as clinical strategies that may contribute to peri-implant tissue stability and reduced marginal bone loss.
- Maintenance and retrievability: Prosthetic retrievability and regular follow-up are important for preventing both biological and technical complications.

These prosthetic factors influence not only peri-implant tissue health but also the prevention of prosthetic complications.

4. Conclusion
The long-term success of implant therapy is strongly influenced by prosthetic design and occlusal management rather than by surgical factors alone. In particular, emergence profile and angle, retention strategy, abutment material, and occlusal control are key prosthetic determinants of peri-implant tissue stability and complication prevention. Therefore, implant treatment should be based on prosthetically driven planning combined with well-designed prosthetic protocols and systematic maintenance strategies.