I have restored this implant recently and would like to know what issues will the patient face in the long run? Implant fracture,screw loosening,occlusal issues etc.
First of all don’t beat yourself up and just try to use a more appropriate fixture next time you replace a molar tooth. While common sense would suggest a hygienic nightmare and an absolute failure, at least my own experience, would suggest to just hang on and be willing to remove/replace some day if needed. The fact that this patient has both second and third molars distal will likely shield them from cantilever issues and I suspect thick attached tissue which will form up nicely around the restoration. While I am not a fan of your choice of fixtures I think this will be just fine…
sometimes the contacts open up
As I look at this I stay stuck on the fact that you utilized a fixture designed based off the Zero Bone Loss Concept and as such it has compounded the problem. Because this fixture is built off of a “Simple” universal platform concept you have been forced to emerge this large molar tooth from a 3.5mm hex which is the same as I would emerge a lateral incisor. While you seem to have followed the placement protocol for this flawed design perfectly you are still left with a large molar tooth emerging from a small platform… but at least you won’t get any crestal bone loss, which could actually be beneficial in this case. NeoDent’ish fixtures with a 3.5mm universal hex are a poor choice when restoring a large molar tooth and this image does a better job at highlighting the mechanics of why this is true then it does at displaying any future problems because at the end of the day this may work perfectly well for many years to come.