Occlusal considerations in implant therapy: clinical guidelines with biomechanical rationale

Abstract

Due to lack of the periodontal ligament, osseointegrated implants, unlike natural teeth, react biomechanically in a different fashion to occlusal force. It is therefore believed that dental implants may be more prone to occlusal overloading, which is often regarded as one of the potential causes for peri-implant bone loss and failure of the implant/implant prosthesis. Overloading factors that may negatively influence on implant longevity include large cantilevers, parafunctions, improper occlusal designs, and premature contacts. Hence, it is important to control implant occlusion within physiologic limit and thus provide optimal implant load to ensure a long-term implant success. The purposes of this paper are to discuss the importance of implant occlusion for implant longevity and to provide clinical guidelines of optimal implant occlusion and possible solutions managing complications related to implant occlusion. It must be emphasized that currently there is no evidence-based, implant-specific concept of occlusion. Future studies in this area are needed to clarify the relationship between occlusion and implant success.

Two prosthetic crowns supported by a single implant in the esthetic zone

“…In spite of scarce scientiic evidence, a number of factors give support to the biomechanical integrity of the single implant-supported prosthesis with cantilever springs: in the anterior maxilla, masticatory load is less than half of that found in the posterior maxilla; 24 implants currently available present a higher percentage of bone-to-implant contact, which is likely to increase anchorage; 25 careful occlusal adjustment 26 providing mild torque in intercuspal contact position, adequate protrusion and lateral guidance movements, especially at the implant abutment; and patient selection excluding those with parafunction.…”

Management of Edentulous Maxilla with Sagittal -Transverse Deficiency Presenting with Repeated Implant Failures: A Case Report

“…Patients with constricted edentulous maxillae pose multiple challenges because the occlusion of these patients falls into cross bite which could result in occlusal interferences and overloading of implant leading to failure 4,7 . Occlusal overload results in crestal bone loss, thus increasing the anaerobic sulcus depth and predisposes the fixture towards progressive peri-implantitis and eventual loss of implant 8,9 .…”

Planning and treatment in oral rehabilitation with implant-supported prostheses using cephalometric analysis

“…For this purpose, some principles of occlusion have been suggested as factors to consider when the occlusion of implant-supported dentures is established, such as the occlusal morphology of the denture orienting the occlusal force in the apical direction, reduced occlusal table, reduced inclination of the cusp, and reduced mesio-distal and vestibularlingual distance of the cantilever 21 . In order to establish an ideal occlusion in implant-supported dentures, prosthetic/surgical planning based on biomechanical principles is necessary 21 . Therefore treatment with implants greatly improves masticatory function and patient satisfaction for a long period.…”