2022 ACP Annual Session

Occlusion as a Predisposing Factor for Peri-implant Disease: A Review

Sang J Lee DMD MMSc, Osamah Alamri BDS, Huilin Cao DDS MS, Yujun Wang DDS, German O Gallucci DMD PhD, Jason D Lee DDS MMSc

Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, MA, USA

Background

•The restoration of dental implants presents a unique challenge due to the intrinsic biomechanical differences between osseointegratedimplants and natural teeth

•Dental implants and teeth respond differently to occlusal loading due to lack of PDL around implants

•Controversy exists regarding the role that occlusion plays in the physiology of the peri-implant complex

Purpose

•The aim of this review is to provide an overview of the scientific literature regarding occlusion as it relates to implant dentistry and peri-implant disease

Materials and methods

•This review presents occlusal loading and its potential effects on the peri-implant complex

•Summarizes generally accepted guidelines for occlusion in implant dentistry

OCCLUSAL FORCE, MAGNITUDE, AND DISTRIBUTION AND IMPLANT COMPLICATIONS

Figure 1. (a) fractured implant i30 with radiographic bone loss. Implant failure possibly caused by nonaxial force from mesial canteliver and bruxism; (b) occlusal view of the fractured implant in the previous radiograph; (c-d) PA radiograph showing implant placed at a non-ideal angle, and subsequently restored with a prosthesis that transfers non-axial forces to the implant;(e) Implant placed distally of the ideal position and result in a mesial cantilever of the final crown.

BIOLOGICAL PROCESS OF PERI-IMPLANT DISEASES

Figure 2. Biologic process of peri-implant mucositis and peri-implantitis. Peri-implant diseases are first initiated with biofilm accumulation. Inflammatory cells infiltrate the peri-implant tissues which could ultimately result in attachment loss and bone loss.

THE EFFECT OF OCCLUSAL LOAD AND OVERLOAD ON THE

PERI-IMPLANT HARD AND SOFT TISSUE COMPLEX

OCCLUSAL CONSIDERATIONS IN IMPLANT DENTISTRY

•There is no clear scientific evidence showing a direct causative relationship between occlusal overload and peri-implant disease. However, occlusal overload may be a contributing factor to peri-implant disease in the presence of inflammation

•The functional mechanisms of occlusion in dental implants differ from that of occlusion in the natural dentition due to the unique biomechanical properties of dental implants

•Optimization of implant occlusion in terms of occlusal scheme as well as prosthetic design is suggested to minimize unfavorable overload on implant restorations in order to reduce the associated complications

•Occlusion related complications in implant dentistry can happen, even with meticulous planning of treatment. Understanding how to diagnose and treat these complications is an essential skill for the prosthodontist

2022 ACP Annual Session

Occlusion as a predisposing factor for peri-implant disease

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