Trauma from occlusion: Peri-implant tissues

Question 1

What is the bone reaction around implants upon functional loading and upon excessive occlusal load?

Answer 1

• Functonal loading: It may enhance osseointegraton (direct bone-implant contact) rather than induce marginal bone loss.
• Excessive occlusal load (supraocclusion): No loss of osseo-integraton or marginal bone.
• Experiments in dogs
• Excessive occlusal load: Loss of osseo-integraton – formaton of fbrous tssue.
• Less dense bone around the failed implants!
• Experiments in monkeys

Question 2

Does bruxism cause bone changes that affect the survival of dental implants?

Answer 2

Unknown what specifc bone changes may bruxism cause.Inconclusive data!

• “Bruxism is a contributng factor of causing the occurrence of dental implant technical/biological complicatons and plays a role in dental implant failure.”
• “Bruxism may signifcantly increase both the implant failure rate and the rate of mechanical and technical complications of implant-supported restoratons.”

Question 3

What factors may lead to implant failure in a bruxer patient?

Associatons have been reported between:

Answer 3

Associatons have been reported between:

1. Bone quality
2. Implant characteristcs (length, surface, etc.)
3. Prosthetics
4. Systemic diseases and medication and implant failure in bruxer patients.

Question 4

What is the effect on the bone when orthodontic forces are applied on dental implants?

Answer 4

• Normal orthodontc forces: No bone loss. Appositon of bone, increased bone density.
• There is a threshold above which the orthodontc forces will lead to implant loss.

Question 5

What is the effect of excessive occlusal load on the bone around a dental implant?

Answer 5

No loss of:

• bone and
• implant stability / integrity

even when under heavy function.

Question 6

Is there any effect on the bone when a lateral static load is applied on an implant?

Answer 6

No bone loss

Adaptve remodeling (greater bone-implant contact)

• [Some studies showed marginal bone loss under certain conditons in animals]

Question 7

How does the tooth-implant connection with fixed prosthesis affect the success rate of the construction?

Answer 7

5-year follow-up-

• No adverse efects of splintng teeth to implants.
• A combinaton of implant and tooth support for FDP is acceptable.

10-year follow-up

• Inconclusive