Implant occlusion: biomechanical considerations for implant-supported prostheses

Clinically, natural occlusal concepts can be applied to implant prostheses. However, a natural tooth has a support design that reduces the forces to the surrounding crest of bone compared to the same region around an implant. If a clinical condition is likely to increase biomechanical stresses, dentists should implement occlusal mechanisms to decrease the stresses and develop an occlusal scheme that minimizes risk factors and allows the restoration to function in harmony with the rest of the stomatognathic system. By avoiding initial and long-term loss of crestal bone surrounding implant fixtures, implant-protected occlusion is proposed as a way to overcome mechanical stresses and strain from the oral musculature and occlusion. Implant-protected occlusion can be accomplished by increasing the surface area of implants, decreasing the width of the occlusal table, improving the force direction, and reducing the magnification of the force. By doing these things, we can minimize overload on bone-implant interfaces and implant prostheses, to maintain an implant load within the physiological limits of individualized occlusion, and ultimately provide long-term stability of implants and implant prostheses. (J Dent Sci, 3(2) : 65 - 74, 2008)