Occlusion principles in implant-supported prosthesis – a literature review

The utilization of oral implantology in the field of dentistry is growing at a rapid rate. Dental implants are frequently preferred options for replacing missing teeth. However, unlike natural teeth, endosseous implants differ concerning the surrounding bone. Forces from occlusal overloading may cause mechanical and biological complications like early implant failure, early crestal bone loss, intermediate to late implant failure, screw loosening, uncemented restoration, component failure, porcelain fracture, prosthesis fracture, and peri- implant disease. Hence, dental implants require different biomechanical considerations from natural teeth as they are more prone to occlusal overloading. In case of increased biomechanical stresses in clinical conditions, the dentist should implement occlusal mechanisms to decrease the stresses. An occlusal scheme that should minimize the risk factors and permit the restoration to function in harmony with the stomatognathic system should be developed.
Implant-protected occlusion is proposed to overcome mechanical stresses and strain from the oral musculature and occlusion by avoiding loss of crestal bone surrounding implant fixtures. Implant-protected occlusion can be established by minimizing the width of the occlusal table, increasing the surface area of implants, reducing the occlusal force, and enhancing the force direction. The dentist can reduce overload on bone-implant interfaces and implant prostheses within the physiological limits, and ultimately provide long-term stability of implants and implant prostheses. This article encapsulates the principles of occlusion that provide biomechanically optimum load distribution in different implant prostheses.