Biomechanics and Occlusion for Implant-Supported Prosthesis

There is an increasing appreciation of the vital role that biomechanics play in the performance of oral implant. The aim of this article is to provide some basic principles that will allow a clinician to formulate a biomechanically valid treatment plan. However, at this point in the history of oral implantology, the clinician should realize that we do not know enough to provide absolute biomechanical rules that will guarantee success of all implants in all situations. To examine the biomechanical questions, one must begin with an analysis of the distribution of biting forcess to implants. Related topics, such as stress transfer to surrounding tissues and interrelationships between bone biology and mechanical loading are major subjects, deserving a separate discussion. Once rigid fixation, angulation, crestal bone level, contour, and gingival health are achieved, stress beyond physiologic limits is the primary cause of initial bone loss around implants. The restoring dentist has specific responsibilities to reduce overload to the bone-implant interface. These include proper diagnosis, leading to a treatment plan designed with adequate retention and form, and progressive loading to improve the amount and density of bone and further reduce the risk of stress beyond physiologic limits. The major remaining factor is the development of occlusal concept in harmony with the rest of the stomagnetic system.

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