How much misfit actually matters — and how to avoid it in full‑arch cases

A new systematic review shows weak clinical links between misfit and bone loss but a signal for screw complications; recent in‑vitro work shows reverse scanbody and laboratory‑scan workflows give the best chance of a truly passive full‑arch fit.

Passive fit is one of those perennial worries in full‑arch implant prosthodontics: clinicians blame misfit for loose screws, fractured components and bone loss, yet the evidence has always been murky. A new 2026 systematic review of long‑term studies finds that high implant survival is common even when small gaps are present, and only one of six qualifying clinical studies showed a statistically higher rate of screw complications with greater misfit (p = 0.005). The reviewers conclude that long‑term clinical evidence is limited and confounding factors (occlusion, prosthesis design, patient parafunction) make direct causal claims unsafe. ([onlinelibrary.wiley.com](