Peri-Implant Bone Loss and Overload: A Systematic Review Focusing on Occlusal Analysis through Digital and Analogic Methods

Abstract

The present review aimed to assess the possible relationship between occlusal overload and peri-implant bone loss. In accordance with the PRISMA guidelines, the MEDLINE, Scopus, and Cochrane databases were searched from January 1985 up to and including December 2021. The search strategy applied was: (dental OR oral) AND implants AND (overload OR excessive load OR occlusal wear) AND (bone loss OR peri-implantitis OR failure). Clinical studies that reported quantitative analysis of occlusal loads through digital contacts and/or occlusal wear were included. The studies were screened for eligibility by two independent reviewers. The quality of the included studies was assessed using the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool. In total, 492 studies were identified in the search during the initial screening. Of those, 84 were subjected to full-text evaluation, and 7 fulfilled the inclusion criteria (4 cohort studies, 2 cross-sectional, and 1 case-control). Only one study used a digital device to assess excessive occlusal forces. Four out of seven studies reported a positive correlation between the overload and the crestal bone loss. All of the included studies had moderate to serious overall risk of bias, according to the ROBINS-I tool. In conclusion, the reported data relating the occlusal analysis to the peri-implant bone level seem to reveal an association, which must be further investigated using new digital tools that can help to standardize the methodology.

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“…Implant loading gradually increased, and screw-retained plastic interim prostheses were placed after a 5.5-month integration period to prevent overloading of the temporomandibular joints. Physiological implant loading increases peri-implant bone density, whereas infraocclusion and implant overloading lead to peri-implant bone loss 47 .…”

Computer-Aided Design/Computer-Aided Manufacturing of Customized Abutment for Rehabilitating a Malpositioned Implant Using Digital Flow: A Case Report

“…The radiograph on Figure 7 , with a five-year follow-up without a history of mucositis or any other discomfort, suggests satisfactory biomechanics and the possibility of good hygiene maintenance. It is worth noting that marginal bone-ridge maintenance may be associated with implantology success [ 34 , 35 ]. Other situations must be analyzed individually.…”

Effect of the Abutment Rigidity on the Wear Resistance of a Lithium Disilicate Glass Ceramic: An In Vitro Study

“…It is estimated that on average 24% of implants will develop peri-implantitis [ 28 ], whereas the incidence of mechanical failure is estimated to be 5.6% to 7.7% [ 29 ]. There are reports that overloading on implants may lead to an increased risk of failure in implant prosthetic treatment, contributing not only to mechanical complications, but also exacerbating the course of biological complications [ 30 , 31 ].…”