Implant complications have become a major challenge for many dentists who placed implants. This lecture is designed to help dentists who placed or restored implant understand what’s new in implant complications, how to avoid these problems and how to predictably mange this emerging concern.  Recent research findings of how surface coating or the titanium particles or restorative designs influence the incidence of implant complications will be discussed. Specifically, the link between restorative designs (e.g., crown contour, distance between crown margin and fixture bone level, residual cement, occlusion…etc) and implant complications will be thoroughly explored.  In addition, this lecture will provide the mechanisms (e.g., surgically triggered, prosthetically triggered and biological induced implant complications) of how implant bone loss and implant failure occurred. Specifically, how to manage implant esthetic and biological complications using submerged (EP-DDS) or non-submerged surgical protocol will be demonstrated. Three decision trees (implant biological complication management, implant treatment based upon defect morphology and implant soft tissue recession classification and proposed management) will be proposed. The treatments for implant diseases/complications include: chemotherapeutic agents, lasers de-contamination, apically positioned flap with or without implantoplasty, implant surface detoxification, lasers, guided bone regeneration, soft tissue grafts (conditioning), implant removal as well as re-implantation will be thoroughly discussed.