Occlusal Scheme Effect on the Biomechanical Response of Full-Arch Dental Prosthesis Supported by Titanium Implants: A Systematic Review

Abstract

Dental implant-supported prosthesis are widely used in oral reconstruction of totally edentulous patients. Nonetheless, one of the most common failures in these cases is caused by overloading from improper occlusion. The aim of this work was to determine if the occlusal scheme influences the biomechanical response in implant-supported dental prostheses. Searches were conduct is several databases (PubMed/MEDLINE, The Cochrane Library, Web of Science, Scopus, LILACS, and Opengrey). We found 632 publications and 521 studies remained after removing duplicates. After applying the inclusion criteria, five studies were used in this systematic review: one clinical trial, one retrospective clinical trial, one in vitro and two in silico. The results show the lack of clinical and laboratory studies about occlusion in implant-supported prostheses. Although there are several studies regarding implant occlusion schemes, there remains a lack of scientific evidence to support that one specific occlusal scheme is superior to another, or to help define the ideal occlusal scheme that improves the clinical outcome. It can be concluded, however, that the proper distribution of loads and the absence of occlusal interferences can increase implant longevity. Thus, more clinical and laboratory studies must be carried out to obtain an occlusal scheme that favors the clinical success of implant rehabilitation.

Influence of Framework Material and Posterior Implant Angulation in Full-Arch All-on-4 Implant-Supported Prosthesis Stress Concentration

“…Implant prostheses rehabilitation has proven efficacy in the treatment of fully edentulous patients in long-term studies [ 1 , 2 ]. However, the process of bone resorption due to physiological and pathological factors [ 3 ] complicates planning for the installation of posterior implants as a prosthetic support [ 4 , 5 ].…”

Evaluation of Zirconia and High Performance Polymer Abutment Surface Roughness and Stress Concentration for Implant-Supported Fixed Dental Prostheses

“…However, the titanium is the most used material due to its mechanical characteristics as strength and resistance to distortion. Systematic reviews have shown excellent results promoting titanium abutments as highly reliable [4][5][6]; however, sometimes it is necessary to replace it by other materials. The usage of titanium as substrate can generate a gray zone effect on the peri-implant marginal mucosa, dampening the treatment aesthetics and the patient satisfaction [7].…”

Influence of CAD/CAM Abutment Heights on the Biomechanical Behavior of Zirconia Single Crowns

“…However, there is a lack of data evaluating the influence of metallic link height on the mechanical behavior of these restorative systems before and after the fatigue cyclic [17]. It is also noteworthy that restorative materials fail under fatigue, especially with lower intensity loads applied for a long period [18][19][20]. In addition, the abutment design may influence the marginal bone loss; however, it is still unclear how this parameter affects the stresses in the peri-implant tissues [18,19].…”

“…It is important for clinicians to identify how occlusal force (normal or excessive) may impact implant success rates. Therefore, for a stable dental treatment, it is important to avoid overloading the dental implants and the bone, which can lead to biological and mechanical problems [20]. In summary, dental implants are exposed to inconstant loading during their life span due to chewing, which may lead to mechanical failure under fatigue [20,21].…”

“…Therefore, for a stable dental treatment, it is important to avoid overloading the dental implants and the bone, which can lead to biological and mechanical problems [20]. In summary, dental implants are exposed to inconstant loading during their life span due to chewing, which may lead to mechanical failure under fatigue [20,21]. These failures can occur in the crown, abutment, implant body, or prosthetic screw [21].…”