Occlusion on a Single Implant-Supported Crown: Any differences?

Abstract

Dental implants react biomechanically to the occlusal forces placed on them, in a different fashion to teeth, which can make them prone to overloading. This can lead to a range of mechanical problems, including screw loosening, ceramic chipping, and fracture of components, but it can also be associated with biological complications such as later peri-implantitis. Appropriate occlusal loading is essential to maintain long-term stability of implant-retained restorations. Clinicians must be aware that, to varying extents, complications do occur with single implant-retained crowns. Dental implants are not a panacea; it is unwise to describe implants as being either perfect or permanent because they are neither. Patients need to understand, well in advance of having implant-based treatment, that the placement of titanium in their jaw(s) will not stop their parafunctional habits, such as clenching or bruxism. Insertion of titanium screws of various types and roughness will certainly not alter their susceptibility to their own plaque-induced inflammatory periodontal disease which is often manifested as peri-mucositis, or later as peri-implantitis in susceptible patients. Based on the available data, this paper provides recommendations to optimise clinical outcomes for single implant-supported crowns. When designing implants, the focus should be on achieving axial forces during chewing. It is wise to minimise horizontal and non-axial loads to avoid potential damage to ceramic or other prosthetic components, and to minimise the risks of bone resorption occurring around the implants themselves at a later stage. Occlusal relationships of implant-retained restorations should be carefully evaluated on a regular basis. Accurate occlusal records of the starting point are extremely helpful in assessing the ongoing status of any restorations.