Single implants and occlusion is a “hot” topic these days. Although specialists and generalists alike are placing implant and restorations frequently, more education on maintenance of implants is required.
Clinicians must be aware of the difference between natural teeth and implants. Natural teeth are connected to bone via the periodontal ligament; whereas, fixed and rigid implants are connected to bone through a direct connection, osseointegration. Because of the way the two entities are connected to bone, the occlusion is also different. Natural teeth can move up to 100 microns vertically or horizontally due to its connection to the periodontium but, there is virtually no compression with implants. If there is movement in an implant, it indicates that the implant has not fused to the bone.
When planning the occlusion on an implant, one has to account for this difference. As such, the implant crown should be out of occlusion by at least 100 microns in a healthy dentition and should only come into full occlusion at the end of the clenching cycle. If the occlusion is too heavy on an implant restoration, it will lead to various issues over time, including:
• Loosening of the implant screw
• Fracture of the implant infrastructure, implant body or screws
It is important that, at regular 6 or 12 month recall intervals, dentists evaluate implants and the occlusion on the implant to identify any issues that may be beginning.
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