Trauma from occlusion: dental implants

Question 1

Occlusion on natural teeth vs implants

Answer 1

Natural tooth: PDL attachment, can adapt to heavy orces, tooth mobility as a physiological / pathological phenomena
Dental implants: Direct bone-implant surface mechanical binding. Continuous bone reodeling at bone-implant surface interface. Implant mobility as a pathological phenomena

Question 2

Primary stability:

Answer 2

stability of implant at the time of placement

bone density and implant design deside

Question 3

Healing at the interface

Answer 3

Bone formation and remodeling.
Time:
Mandible … 3 months
Maxilla… 6 months

Question 4

Functional loading of the implant

Answer 4

Immediate: at time of placement
Early loading: before healing
late: following 3 or 6 months based on location

Question 5

Effects of implants in excessive occlusion

Answer 5

Fracture of screw porcelain
increasing mobility of ADJACENT teeth
Eruption/malocclusion of adjaccent teeth

Question 6

Mechanoreception vs Osseoperception

Answer 6

Tooth loss eliminates the pdl receptors and, thus, disconnects the neural feedback pathways.
“Osseoperception” is defined as mechanoreception derived from TMJ, MUSCLE, CUTANEOUS, MUCOSAL and PERIOSTEAL RECEPTORS which provide mechanosensory information for oral kinaesthetic sensibility in relation to jaw function and artificial teeth.

Question 7

Is Occlusal trauma a primary or secondary etiological factor for implants?

Answer 7

Occlusal trauma is a secondary etiological factor for periodontal disease but …
it can be a primary etiological factor for peri-implant disease.

Question 8

How to make implants tolerate bruxism:

Answer 8

LONGER AND WIDER DENTAL IMPLANTS TO TOLERATE CHALLENGES !!!

- SURROUNDED WITH THICK BONE SUPPORT

Question 9

What is the best dimensions of implant to tolerate forces?

Answer 9

Research has shown that implant diameter is more critical than length in reducing the bone stress.

Question 10

What causes more strain: lateral or vertical loads?

Answer 10

Lateral loads induced high bone strain and implant stress than vertical loads

Question 11

Distal tilted implants vs distal vertical implants

Answer 11

Distal tilted implants in complete-arch prostheses allow a reduction of compressive stresses at the distal peri-implant bone BUT…
Distal tilted implants can produce higher tensile stresses when compared with distal vertical implants.