The consensus statement is the outcome of the Osstem Global Consensus Meeting, a dedicated scientific initiative. This meeting brought together ten prosthodontic experts earlier this year to conduct structured evidence reviews and reach agreement on clinical recommendations.

The consensus emphasised that implant fractures, although rare, can have serious consequences and are typically multifactorial. Common causes include poor planning, inappropriate implant selection and occlusal overload—particularly in the case of bruxers and single posterior restorations.

Peri-implantitis is similarly multifactorial, involving both biological and technical factors, such as implant malposition, excess cement, biomechanical stress and implant–abutment interface issues. These can lead to marginal bone loss and increased risk of disease.

To mitigate these risks, the panel formulated guidelines addressing prosthetic design, treatment planning and patient-specific risk factors. Key areas of consensus included:

• the role of biomechanical overload in implant fracture;
• the impact of emergence profile design on peri-implant tissue health;
• the influence of implant positioning and connection geometry on marginal bone loss; and
• the importance of occlusal scheme and restorative materials, especially in high-risk cases such as bruxers.

Consensus recommendations to prevent implant fracture addressed:

• prosthetically driven implant positioning and adherence to manufacturer protocols, including the selection of appropriate implant diameters;
• use of computer-guided surgery (CAD/CAM techniques);
• use of TS implants (Osstem) in the posterior region: 4.0 mm in diameter for premolars and 4.5 mm for molars;
• use of SS implants (Osstem) in cases where mechanical overload is anticipated;
• sufficient peri-implant bone and soft-tissue thickness (≥ 1–2 mm);
• appropriate placement depth (up to 2 mm sub-crestally when indicated);
• placement adjusted according to mucosal thickness, soft-tissue conditions and aesthetic considerations; and
• strict compliance with manufacturer guidelines regarding the exclusive use of original components and specified torque values.

Consensus recommendations to reduce peri-implantitis risk included:

• Occlusal overload, systemic conditions and patient habits such as smoking must be considered during treatment planning.
• Surgical and prosthetic strategies must be tailored to the patient to help reduce the risk of crestal bone loss and inflammation.
• Emergence profiles must be designed according to the quantity and quality of peri-implant soft and hard tissue.

The panel members underscored the importance of individualised, interdisciplinary treatment planning and early intervention. Prevention—through careful prosthetic design and risk management—is key to long-term implant success, they explained. Although the recommendations are primarily based on narrative reviews, retrospective data and expert opinion, they provide practical, clinically relevant strategies that may improve daily practice outcomes.

The Osstem Implant Scientific Community (OIC) has hosted consensus meetings since 2017 and formally launched the Osstem Global Consensus Meeting initiative in 2023. The committee comprises three divisions—surgery, prosthodontics and digital—and conducts annual research to propose globally applicable guidelines in implant dentistry.

Dr Cho In-ho, director of Osstem’s dental research institute, said: “The goal of the Osstem Global Consensus Meeting is to elevate the global standard of care by providing scientifically grounded, clinically validated guidelines that improve implant treatment success and patient outcomes.” Dr Cho continued: “Since its establishment in 2001, the OIC has trained over 130,000 dentists worldwide. With Osstem’s dental research institute, comprising 1,300 leading experts and a growing network of master course alumni, we are building one of the most promising scientific communities in implant dentistry.”

The paper, titled “Prosthetic guidelines to prevent implant fracture and peri-implantitis: A consensus statement from the Osstem Implant Community”, was published online on 16 June 2025 in Prosthesis and forms part of the OIC’s Global Consensus Report.

In addition to exploring the implant systems discussed in the paper, clinicians are encouraged to view Osstem’s comprehensive online lecture series to learn more about implant options tailored to various clinical scenarios and surgical techniques.