BIOLOGICAL AND TECHNICAL COMPLICATIONS IN TOOTH- AND IMPLANT-SUPPORTED FIXED AND HYBRID PROSTHESES: ETIOPATHOGENESIS, RISK FACTORS AND PREVENTIVE STRATEGIES – A NARRATIVE REVIEW

Andronache Alina, Norina Forna, Scutariu Monica

DOI : 10.62610/RJOR.2026.2.18.14

ABSTRACT

Aim of the study: Fixed and hybrid prosthodontic restorations supported by natural teeth or dental implants are widely used in the rehabilitation of partially or completely edentulous patients. This narrative review aims to evaluate current evidence regarding biological and technical complications associated with these restorations, focusing on etiopathogenesis, risk factors, clinical implications, and preventive strategies.Materials and methods: A comprehensive search was conducted in PubMed, Scopus, Web of Science, and Google Scholar. Systematic reviews, randomized controlled trials, and high-quality observational studies were included to synthesize evidence on long-term complications of tooth- and implant-supported fixed and hybrid prostheses.Results: Biological complications include secondary caries, pulpal pathology, peri-implant mucositis, and peri-implantitis. Technical complications comprise restorative material fractures, loss of retention, wear of prosthetic components, screw loosening or fracture, and framework failures. The evidence indicates a multifactorial etiology involving prosthetic design, biomechanical loading, material characteristics, clinician-related factors, and patient-specific risk profiles.Conclusions: Biological and technical complications remain clinically relevant despite advances in materials and techniques. Their occurrence is influenced by multiple interacting factors, and a thorough understanding of their mechanisms is essential for improving treatment planning, optimizing prosthetic design, and establishing effective maintenance protocols.