• The Journal of the Korean dental association
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• v.53 no.6
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• pp.418-426
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• 2015

The appropriate occlusion is one of the most important factors for the long-term success of implant and its restorations. The purpose of this review is to investigate and define occlusal considerations to reduce failure of implant prostheses. The physiological movement of implants is markedly lower than that of natural teeth and they also lack in occlusal sensitivity. Proper occlusal pattern may be assigned to compensate for the biological disadvantages and occlusal contacts must be formed where the cantilever effect is minimized. Moreover, the long-term success of implants after osseointegration can be assured by reducing early occlusal loading to avoid implant overloading and selecting appropriate occlusion material. Occlusal overload was brought by the number and location of occlusal contacts, which are under the clinician's control. The concept of implant occlusion is based on the concepts derived from traditional prosthetics. Moreover, there are few evidence on the concept or design of implant occlusion. Several occlusal design was recommended for implant prosthesis. Mutually protected occlusion, group function occlusion and bilateral balance occlusion was recommended for the specific types of implant restorations. This article reviews proper design of occlusion for implant restoration and offers occlusion strategy clinically.

• Journal of Periodontal and Implant Science
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• v.43 no.2
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• pp.51-57
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• 2013

Implant treatment has become the treatment of choice to replace missing teeth in partially edentulous areas. Dental implants present different biological and biomechanical characteristics than natural teeth. Occlusion is considered to be one of the most important factors contributing to implant success. Most literature on implant occlusal concepts is based on expert opinion, anecdotal experiences, in vitro and animal studies, and only limited clinical research. Furthermore, scientific literature regarding implant occlusion, particularly in implant-supported fixed dental prostheses remains controversial. In this study, the current status of implant occlusion was reviewed and discussed. Further randomized clinical research to investigate the correlation between implant occlusion, the implant success rate, and its risk factors is warranted to determine best clinical practices.

• The Journal of Advanced Prosthodontics
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• v.9 no.1
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• pp.45-51
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• 2017

PURPOSE. This study aims to investigate the effects of four different lateral occlusion schemes and different excursions on peri-implant strains of a maxillary canine implant. MATERIALS AND METHODS. Four metal crowns with different occlusion schemes were attached to an implant in the maxillary canine region of a resin model. The included schemes were canine-guided (CG) occlusion, group function (GF) occlusion, long centric (LC) occlusion, and implant-protected (IP) occlusion. Each crown was loaded in three sites that correspond to maximal intercuspation (MI), 1 mm excursion, and 2 mm excursion. A load of 140 N was applied on each site and was repeated 10 times. The peri-implant strain was recorded by a rosette strain gauge that was attached on the resin model buccal to the implant. For each loading condition, the maximum shear strain value was calculated. RESULTS. The different schemes and excursive positions had impact on the peri-implant strains. At MI and 1 mm positions, the GF had the least strains, followed by IP, CG, and LC. At 2 mm, the least strains were associated with GF, followed by CG, LC, and IP. However, regardless of the occlusion scheme, as the excursion increases, a linear increase of peri-implant strains was detected. CONCLUSION. The peri-implant strain is susceptible to occlusal factors. The eccentric location appears to be more influential on peri-implant strains than the occlusion scheme. Therefore, adopting an occlusion scheme that can reduce the occurrence of occlusal contacts laterally may be beneficial in reducing peri-implant strains.

• Journal of Dental Rehabilitation and Applied Science
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• v.20 no.1
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• pp.57-70
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• 2004

The significance of occlusion has regained its popularity in dentistry with the introduction of implant therapy. Literature has reported that the clinical success and longevity of dental implants can be achieved by biomechanically controlled occlusion. Occlusal overload is known to be one of the main causes for implant failure. Evidences have suggested that occlusal overload contribute to early implant bone loss as well as deosseointegration of successfully integrated implants. Unlike natural teeth, osseointegrated implants are ankylosed to surrounding bone without the periodontal ligament (PDL) which provides mechanoreceptors as well as shock-absorbing function. Moreover, the crestal bone around dental implants may act as a fulcrum point for lever action when a force (bending moment) is applied, indicating that implants/implant prosthesis could be more susceptible to crestal bone loss by applying force. Hence, it is essential for clinicians to understand inherent differences between teeth and implants and how force, either normal or excessive force, may influence on implants under occlusal loading. The purposes of this paper are to review the importance of implant occlusion, to establish the optimum implant occlusion with biomechanical rationale, to provide clinical guidelines of implant occlusion and to discuss how to manage complications related to implant occlusion.

• The Journal of the Korean dental association
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• v.58 no.8
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• pp.496-504
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• 2020

The osseointegrated implants react biomechanically in a different pattern to occlusal force, due to lack of the periodontal ligament unlike the natural teeth. The implants show markedly less movement and limited tactile sensitivity compared with the natural teeth. The implant occlusion concept aims to avoid overloading on the implants and to direct occlusal loads along the longitudinal axis of the implants, in order to compensate for the different biomechanics of the implants. Although many guidelines and theories on implant occlusion have been proposed, few have provided strong supportive evidence. Moreover, the outcome of treatment often quite successful in spite of different concepts of occlusion and there is an increasing tendency to doubt about the strict theoretical implant-specific occlusion concept. The purpose of this article is to review the previous reports about the concept of implant occlusion and discuss clinical occlusal considerations in implant rehabilitations.

• The Journal of Advanced Prosthodontics
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• v.13 no.2
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• pp.79-88
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• 2021

Purpose. To assess peri-implant stress distribution using finite element analysis in implant supported fixed partial denture with occlusal schemes of cuspally loaded occlusion and implant protected occlusion. Materials and methods. A 3-D finite element model of mandible with D2 bone with partially edentulism with unilateral distal extension was made. Two Ti alloy identical implants with 4.2 mm diameter and 10 mm length were placed in the mandibular second premolar and the mandibular second molar region and prosthesis was given with the mandibular first molar pontic. Vertical load of 100 N and and oblique load of 70 N was applied on occlusal surface of prosthesis. Group 1 was cuspally loaded occlusion with total 8 contact points and Group 2 was implant protected occlusion with 3 contact points. Results. In Group 1 for vertical load, maximum stress was generated over implant having 14.3552 Mpa. While for oblique load, overall stress generated was 28.0732 Mpa. In Group 2 for vertical load, maximum stress was generated over crown and overall stress was 16.7682 Mpa. But for oblique load, crown stress and overall stress was maximum 22.7561 Mpa. When Group 1 is compared to Group 2, harmful oblique load caused maximum overall stress 28.0732 Mpa in Group 1. Conclusion. In Group 1, vertical load generated high implant stress, and oblique load generated high overall stresses, cortical stresses and crown stresses compared to vertical load. In Group 2, oblique load generated more overall stresses, cortical stresses, and crown stresses compared to vertical load. Implant protected occlusion generated lesser harmful oblique implant, crown, bone and overall stresses compared to cuspally loaded occlusion.

• The Journal of Advanced Prosthodontics
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• v.13 no.4
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• pp.216-225
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• 2021

PURPOSE. The aim of this study is to evaluate the effects of canine guidance occlusion and group function occlusion on the degree of stress to the bone, implants, abutments, and crowns using finite element analysis (FEA). MATERIALS AND METHODS. This study included the implant-prosthesis system of a three-unit bridge made of monolithic zirconia and hybrid abutments. Three-dimensional (3D) models of a bone-level implant system and a titanium base abutment were created using the original implant components. Two titanium implants, measuring 4 × 11 mm each, were selected. The loads were applied in two oblique directions of 15° and 30° under two occlusal movement conditions. In the canine guidance condition, loads (100 N) were applied to the canine crown only. In the group function condition, loads were applied to all three teeth. In this loading, a force of 100 N was applied to the canine, and 200-N forces were applied to each premolar. The stress distribution among all the components of the implant-bridge system was assessed using ANSYS SpaceClaim 2020 R2 software and finite element analysis. RESULTS. Maximum stress was found in the group function occlusion. The maximum stress increased with an increase in the angle of occlusal force. CONCLUSION. The canine guidance occlusion with monolithic zirconia crown materials is promising for implant-supported prostheses in the canine and premolar areas.

• The Journal of the Korean dental association
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• v.51 no.5
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• pp.242-249
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• 2013

The proper occlusal design is one of the most important factors for the long-term success. The purpose of this research is to investigate and define occlusal considerations to reduce failure of implant-supported fixed prostheses. The physiological movement of implants is markedly lower than that of natural teeth and they also lack in occlusal sensitivity. Proper occulsal pattern may be assigned to compensate for the biological disadvantages and occlusal contacts must be formed where the cantilever effect is minimized. Moreover, the long-term success can be assured by reducing early occulsal loading to avoid implant overloading and selecting appropriate occlusion material.

• Journal of Korean Dental Science
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• v.14 no.1
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• pp.32-39
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• 2021

'Crossed occlusion' is the condition in which occlusal intercuspation is lost when several teeth on upper and lower jaw remain. This report describes a clinical case in which a patient had two upper-left posterior teeth and two lower-right posterior teeth; typically known as left-right crossed occlusion. Considering the patient's general condition and financial situation, the treatment plan included placement of two implants on each jaw against the remaining teeth using surgical guide. To find out the ideal position of implants, digital diagnostic wax-up was preceded by superimposing the cast and cone beam computed tomography image, which was aided with radiographic stents. The consequent surveyed implant bridge provided stable vertical stop for fabrication of the implant assisted removable partial dentures. The patient was satisfied with the functionality and esthetics of definitive prosthesis.

• The Journal of the Korean dental association
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• v.55 no.12
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• pp.842-849
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• 2017

The term, 'crossed occlusion' implies clinical situation in which the residual teeth in one arch have no contact with those in the antagonistic arch, resulting in the collapse of occlusal vertical dimension. The treatment goal of this pathologic condition is restoration of the collapsed vertical dimension and stabilization of abnormal mandibular position. Previously, konus removable prostheses or tooth supported overdentures were suggested to solve crossed occlusion. Nowadays, dental implants have been used for definitive support to solve this problem. In this case report, a 65 years old female patient had a crossed occlusion, in which the maxillary posterior residual teeth and mandibular anterior residual teeth cross. Interim removable and fixed dental prostheses were used to confirm the proper vertical and horizontal jaw relation. After that, the mandibular posterior edentulous region was restored with implant-supported fixed dental prostheses. Computer tomography guided implant surgery was performed according to the concept of the restoration-driven implant placement. The maxillary anterior edentulous region was restored with Kennedy class IV removable prosthesis, considering the patient's economic status. The patient's jaw position and prostheses have been well maintained at the follow-up after 6 months of definitive restoration. The antero-posterior crossed occlusion problems appeared to be effectively solved with the combination of removable in one arch and implant-supported fixed prostheses in the other.