Complaints about Implant Restorations?

You pretty much nailed the main ones. Not so much the restorations but the time for integration to occur is a common theme. I use screw retained whenever possible so there's some times the accesses are hard to mask.

The most common complaint I hear is about food impaction around single tooth posterior restorations. I explain to patients and show them in a mirror that sometimes when a tooth has been extracted, the site shows loss of the interdental papilla. This will result in a lack of tissue that allows food particles esp. small seeds, pieces of nuts to lodge inter-proximally. We can not always contour a restoration to avoid this, or grow new papillae, and has nothing to do with tight inter-proximal contacts. They need to carry around toothpicks!

I am concerned about the mesial drift of natural teeth located mesially to implant supported crowns. This may occur after a few years of service. The dilemma is should the implant be remade or the tooth restored with a distal restoration? What if the tooth is virgin? I have orthodontically moved the errant tooth distally to resolve the open contact. Dennis Flanagan DDS MSc

Do not "sell" implants as a restoration that is as good as what God put there to start out. Patients who do not have unrealistic expectations of how the implant restorations will look and function will expect the minor inconveniences that are associated with implant restoration. Any patient expecting that the new expensive restoration to be better than their own teeth ever were will never be satisfied, but If the restoration turns out to be better than the teeth were then you are a real hero.

Regarding full arch solid zirconia restorations... The traditional screw in requires many lab related appointments with cumbersome tiny screws and huge impression copings; and how about when the anterior are at an angle? An angle wrench is the answer? Wow! Cleaning with floss threaders and coming into the office to have composite resin removed from tiny holes, then unscrewing, then rescrewing, and who knows where the exit holes will be?? This is a lot of chair time for the doctor and the patient. Common sense says to do something that still gives the patient what they want...teeth that look good and stay in all the time UNLESS they want to remove them. I have trademarked the "CLIB" Comfort Lock Implant Bridge. It circumvents all the hardships of screws. No stripped out screws, no broken screws, no angled wrenches, chair time of an overdenture, maintenance without flossing at home, retention of 16+ pounds of force if desired, The answer is using Zest Locator attachments picked up inside the bridge. Way less chair time, way less lab work/complications, easy removability, easy cleans ability, beautiful aesthetics and durability. Happy patient...Happy Doctor