Background <p>Edentulism has significant functional and psychosocial consequences, and full-arch implant-supported fixed dental prostheses (FDPs) have become one of the most reliable rehabilitation options. However, long-term outcomes of prostheses due to prosthesis-related and patient-related risk factors remain limited. Thus, this study aimed to evaluate the long-term clinical performance, rates of complication types of full-arch implant-supported FDPs over a 4-10-year follow-up period. Additionally, the potential influence of patient- and prostheses- related risk factors—particularly bruxism, opposing arch type, retention system, and cantilever configuration—was assessed.</p> Methods <p>This retrospective study included 24 patients (13 males, 11 females; aged 39–77) treated between 2015 and 2020 with complete or single-arch edentulism received full-arch implant-supported FDPs. A total of 180 implants were placed in 34 edentulous arches, 24 of the implants were angled in posterior regions. Eighteen arches were restored with cement-retained prostheses, and 16 with screw-retained prostheses. Standardized clinical and radiographic examinations were performed at follow-up visits to record periimplant conditions, marginal bone levels and prosthetic complications. Outcomes were documented descriptively at the prosthesis and patient levels.</p> Results <p>However, the cumulative prosthesis survival probability at 5 and 10 years were 80% and 60%, respectively. The cumulative success probability (complication-free) was 61.8% at 1 year, 26.5% at 3 years, and 14.7% at 5 years. By the 6th year, all prostheses (100%) had experienced at least one minor complication, with a median complication-free time of 3 years. “Probable” bruxism was significantly associated with chipping (<i>p</i> = 0.049) and a higher rate of minor complications in the mandible (<i>p</i> = 0.015). However, no significant correlation was found between cantilever length or prosthetic material and marginal bone loss (<i>p</i> &gt; 0.05).</p> Conclusions <p>Full-arch implant-supported FDPs demonstrated stable clinical performance over 4–10 years, with manageable technical complications. The present study contributes to the existing literature by providing long-term, single-center data with standardized follow-up and by presenting detailed implant-, prosthesis-, and patient-level complication profiles. Bruxism may increase the likelihood of certain technical complications, though further studies with larger samples are required to confirm.</p> Trial registration <p>Not applicable.</p>