Identifying occlusal overload and how to deal with it to avoid marginal bone loss around implants.

Abstract

Occlusal overloading is the primary cause of biomechanical implant complications, which include fracture and/or loosening of the implant fixture and/or prosthetic components. It may also disrupt the intricate bond between the implant surface and bone, leading to peri-implant bone loss and eventual implant failure. This paper was aimed at identifying and evaluating clinical and radiographic parameters relevant for diagnosing occlusal overloading of oral implants. It also discusses its management in order to prevent peri-implant marginal bone loss. An electronic literature search for relevant studies, examining the relationship between occlusal overloading and peri-implant bone loss, was conducted in the PubMed database. Clinical human studies published in English with a minimum of 10 implants were included. Seven articles were identified. Occlusal overloading was found to be positively associated with peri-implant marginal bone loss. Preventing occlusal overloading involves conducting comprehensive examinations, treatment planning, precise surgical and prosthetic treatment executions, and regular maintenance. If occlusal overloading occurs, management of biomechanical implant complications and preventing/treating peri-implant bone loss involves surgical and prosthetic treatment modalities. They include occlusal treatment, repair and replacement of defective prosthetic components, and surgical treatment of the bony craters.