Dental implant restorations are highly predictable—but they’re not immune to failure. Whether due to mechanical breakage, esthetic misalignment, or biological complications, restorations occasionally need to be redone. A clear remake policy helps clinics respond swiftly, protect their reputation, and manage patient expectations effectively.
An implant restoration failure is manageable when clinics have clear remake protocols, defined lab responsibilities, and transparent communication with patients.
What Types of Implant Restoration Failures Can Occur?
From our perspective here at the lab, when a restoration comes back to us, it often falls into a few key categories. While the clinician sees the issue chairside, we analyze the component itself—the chips, the fit, the screw channel. Here’s how we classify the types of failures we most commonly encounter
Classification of implant restoration failure types
Mechanical Failure (Chipping, Fracture, Loosening)
We analyze fractured pieces under magnification. Often, we can tell if the fracture originated from a design stress point that we might have queried with the clinic during planning, or if it’s purely due to excessive occlusal force or parafunction beyond the material’s limit.
- Posterior crowns may chip under high load or bruxism.
- Abutment screws can loosen due to improper torque or micromovement.
- Cracks in zirconia may result from over-reduction or thin design.
Biological Complications (Peri-Implantitis, Bone Loss)
- Poor hygiene or residual cement may trigger inflammation.
- Bone loss can occur due to excessive occlusal forces or poor soft tissue seal.
- Severe peri-implantitis may necessitate removal of the entire restoration.
Esthetic or Occlusal Misfit
- Color mismatch or shade issues in anterior crowns.
- Emergence profile not matching adjacent gingiva.
- High occlusion leading to discomfort or TMJ tension.
Cementation or Screw-Retained Instability
- Subgingival cement residue can lead to peri-implant disease.
- Improper screw torque may compromise seating.
- Misalignment complicates retrievability.
✅ Restoration failure can arise from mechanical, esthetic, or biological issues – TRUE
Explanation: Understanding the type of failure helps determine if the issue is clinical, lab-related, or patient-driven.
❌ Once the implant is integrated, the restoration never fails – FALSE
Explanation: Restorative failures are possible years after successful integration.
What Are the Common Causes of These Failures?
Based on the remakes we receive and the clinical cases we help plan, we’ve compiled a list of the most common culprits behind restoration failures. It’s often a combination of factors, and understanding the root cause from both the clinical and technical sides is crucial for prevention.
Implant failure root causes chart
Poor Case Planning or Diagnostic Oversights
- Failure to use CBCT may miss bone angulation issues.
- Insufficient vertical clearance can weaken restorations.
- Lack of esthetic mock-ups can lead to patient dissatisfaction.
Incompatible Components or Poor Fit
- Third-party parts with mismatched tolerances.
- Non-indexed abutments may rotate or misseat.
- Poor screw access angle complicates retrievability.
Subpar Lab Work or Milling Tolerances
Detecting issues like overmilled margins requires meticulous post-milling quality control at our end. We use specialized scanning and visual checks against the design file because we know that a microscopic misfit can lead to clinical issues down the line.
| Lab Error | Potential Complication |
|---|---|
| Overmilled zirconia coping | Increased fracture risk |
| Open contact area | Food impaction, drifting teeth |
| Under-polished margins | Gingival irritation, poor hygiene |
Patient Compliance or Parafunctional Habits
- Bruxism without a guard increases risk of fracture.
- Poor hygiene may lead to peri-implantitis.
- Missed follow-ups prevent early issue detection.
✅ Failures are often preventable through proper planning and communication – TRUE
Explanation: Most failures trace back to planning gaps, poor fit, or unmanaged risk factors.
❌ Failure causes are usually random and untraceable – FALSE
Explanation: Each failure is typically linked to a specific procedural or technical cause.
What Should a Proper Remake Policy Include?
A clear, fair remake policy is essential not just for the clinic, but for us at the lab too. It eliminates ambiguity, streamlines the process, and helps us maintain a strong partnership. From our experience processing many remakes, here’s what makes a policy truly effective.
Dental remake policy document with eligibility terms
Time Window for Eligibility
- 6–12 months is typical for restoration-only warranty.
- Fractures covered if under load-tested conditions.
- Outside window = partial charge or denial.
Scope: Crown Only vs. Full System
- Most remakes cover only the crown.
- Abutment or screw often excluded unless proven defective.
- Implants themselves are rarely covered in restoration remakes.
Return/Destruction Requirement for Originals
- Original crown must be returned for remake approval.
- Destruction confirmation may be required.
- Prevents multiple remake claims from one failure.
Documentation Required for Submission
- Intraoral photos (pre- and post-failure).
- STL files or model scans.
- Description of torque, cement, and patient symptoms.
✅ A written remake policy protects both clinic and lab from disputes – TRUE
Explanation: Defined rules improve turnaround and clarify remake responsibilities.
❌ Remake criteria can be handled verbally on a case-by-case basis – FALSE
Explanation: Informal remake handling leads to delays and confusion.
How Do Labs Typically Handle Remake Requests?
The first thing we do is pull up the original scan and design file. We compare it against the failed restoration and any photos provided. Was the original margin design too thin? Did the scan capture the implant position accurately? This is our internal detective work.
Dental technician analyzing remake request
Review of Original Files and Photos
- Compares design file vs. failed crown for match.
- Looks for margin, fit, or contact errors.
- Evaluates whether cementation or torque contributed to failure.
Determining Lab vs. Clinical Responsibility
| Issue Observed | Responsible Party |
|---|---|
| Over-contoured crown | Lab (design error) |
| Incorrect cement technique | Clinic |
| Missing patient documentation | Shared or denied case |
Turnaround Time for Priority Remakes
- Esthetic zone cases prioritized.
- Average: 3–5 working days.
- Complex remakes may require full redesign.
Charge vs. No-Charge Policy Thresholds
- Lab error = no charge
- Clinical error = full or partial charge
- Esthetic dissatisfaction = lab discretion
✅ Lab remake review follows structured documentation and criteria – TRUE
Explanation: File review ensures quality control and fair decision-making.
❌ Labs must remake any failed crown regardless of the cause – FALSE
Explanation: Labs only remake if the failure is within scope and proven.
How Can Clinics Minimize Restoration Failure Risk?
As a lab committed to quality, we welcome clinics asking about our QA steps. Ask us about our milling machine calibration logs, our post-milling inspection protocols, and how we verify passive fit before sending the restoration. That transparency is key to a trusting partnership.
Implant restoration QA checklist
Use of Digital Planning and Guided Surgery
- CBCT ensures ideal angulation and bone engagement.
- Digital planning improves emergence profile control.
- Guided placement minimizes prosthetic misfit.
Lab Selection Based on QA Consistency
- Track remake rates by lab partner.
- Request lab’s internal QC procedures.
- Use labs with ISO or DAMAS certification.
Reinforcement Protocols for Bruxism Cases
- Night guard is essential post-restoration.
- Avoid layered ceramics in high-load areas.
- Customize occlusion with canine guidance.
Strict Delivery and Torque Protocol Adherence
While torquing is a clinical step, we understand its critical importance for restoration longevity. Our design process aims to create abutment/restoration interfaces that facilitate correct torque application and minimize stress on the screw/cement interface, but accurate clinical execution is vital.
- Use manufacturer-specific torque drivers.
- Always confirm fit with radiograph.
- Avoid over-torquing or under-seating abutments.
✅ Proactive protocol adherence drastically reduces restoration failure – TRUE
Explanation: Workflow discipline and risk screening lead to fewer remakes.
❌ Failure risk cannot be lowered regardless of technique – FALSE
Explanation: Most failure points are preventable through planning and execution.
What Should Be Communicated to Patients?
Setting expectations early prevents conflict if issues arise later.
Clinician explaining remake clause to patient
Consent Form Language on Remakes
- Include clause: “Restorations may require remake within 12 months.”
- Define what’s covered by clinic vs. lab vs. manufacturer.
- Get patient initials on relevant sections.
Cost Implications and Timeline
- “No-charge remake if failure due to lab or material issue within 6 months.”
- “Partial charge if failure due to trauma or hygiene lapse.”
- “Remake typically takes 5–10 days.”
Transparency on Warranty Scope
- Some manufacturers cover abutment, not crown.
- Labs may warranty for 6–12 months.
- Clarify what happens if patient delays follow-up.
Framing Restoration Failure as a Manageable Event
- “Restorations sometimes require adjustments—it’s part of quality control.”
- Emphasize retrievability and technical support.
- Reassure patient that resolution is routine.
✅ Proactive communication builds trust and reduces remake stress – TRUE
Explanation: Informed patients are less likely to panic if something breaks.
❌ Avoid mentioning remakes to maintain confidence – FALSE
Explanation: Surprise issues without preparation damage trust more than honesty.
Conclusion
As a lab, our goal isn’t just to mill a beautiful crown; it’s to be your partner in preventing the headaches of remakes. We build quality control and technical consultation into every case because we know that minimizes chair time and patient issues for you, and reduces costly remakes for everyone.
- Know what types of restoration failures to expect
- Identify the underlying causes
- Implement clear remake policies
- Align with labs that support transparent review
- Follow protocols that reduce remake risk
- Prepare patients with clear and kind communication
Take the Next Step
Need help creating your clinic’s remake policy or staff training guide? We can provide templates, consent forms, and technician-friendly SOPs to streamline your entire restoration workflow.
