IMPLANT OCCLUSION

1. Dr. Shari.S.R, Junior resident; Dept of Prosthodontics | GDC Trivandrum
Occlusal Schemes in
Implants

2. Occlusion In Implants
1. Introduction
2. Diff between natural tooth and implants
3. Development of IPO
4. 14 considerations for IPO
5. Occlusal guidelines for different clinical situations
6. Review of literature.
7. Conclusion

3. Introduction
Occlusion in osseointegrated prosthesis
A prosthesis that is retained, or retained and supported by implants.

4. 7
Table 1. Comparison between tooth and implant
Tooth Implant
Connection PDL Osseointegration
Proprioception Periodontal mechano receptors Osseoperception
Tactile sensitivity High Low
Axial mobility 25-100ևm 3-5ևm
Movement phases Two phases
Primary: nonlinear and complex
Secondary: Linear and elastic
One phase
Linear and elastic
Movement
patterns
Primary : Immediate movement
Secondary: Gradual movement
Gradual movement
Fulcrum to lateral
forces
Apical third of root Crestal bone
Load bearing
charcteristics
Shock absorbing function
Stress distribution
Stress concentration at
crestal bone
Signs of overloading PDL thickening,mobility,wear
facets,fremitus,pain
Screw loosening,or fracture,
abutment or prosthesis
fracture,bone loss,implant
fracture.

5. 8
Tooth and Implant compared
Kim Y, Oh T-J, Misch CE, Wang

6. Tooth Movement vs Implant movement.
Lateral
Movement 50-108µm
no movement
Vertical movement
8 to 28µm
size
shape
no of
roots

7. Understanding difference between natural teeth and implants
Will help in developing occlusal harmony with the implants
NATURALTEETH
Protected by
Periodontal receptors or tactilereceptors
(Shock absorbers)
IMPLANTS
No such receptors
Occlusal
scheme of
natural teeth
Occlusal
scheme
of implants
(Modifications has to be done)

8. Multitude of difference between natural teeth and implant
IPO
also called MEDIALLY POSITIONED LINGUALIZED OCCLUSION
Misch and
Bidez

9. LONGEVITY AND SUCCESS
IMPLANT PROTECTIVE OCCLUSION.
DECREASE STRESS AT IMPLANT BONE INTERFACE
IPO

10. 1. Elimination Of Premature Contact
2. Occlusal Contact Position
3. Parafunction
4. Cantilevers
5. Crown height
6. Crown Contour
7. Favoring Weak Arch
8. Occlusal Material
9. Implant Body And Load Direction
10. Cuspal Angle
11. Controlling Occlusal Table Width
12. Mutually Protected Occlusion
13. Loading Time
14. Provide Adequate Surface Area
Considerations for following implant protected occlusion scheme

11. Implant protective occlusion
1. Implant Angle
2. Cusp Angle
3. Mutually Protected
Occlusion
4. Occlusal Table Width
1. Loading Time
2. Adequate Surface
Area (implant
number, width &
length)
1. Premature Contact
Elimination
2. Occlusal Contact Position
3. Cantilever Prosthesis
4. Crown Height
5. Crown Contour
6. Parafunction
7. Favouring weak arch
8. Occlusal material
REDUCE FORCE
MAGNIFICATION
IMPROVE FORCE
DIRECTION
INCREASE
SUPPORT AREA
Mnemonics: POP is the C³FO

12. Premature contact
Ipo and premature contact
DIVERTS
MANDIBLE
INTERFERES
HARMONIOUS
GLIDING
MOVEMENT OF
DEFLECTS
POSITION OF
CONDYLE,
TEETH OR
PROSTHESIS
MANDIBLE

13. REMOVE PREMATURE
CONTACT
PRIOR TO INSERTION OF IMPLANT
PROSTHESIS ALL OCCLUSAL
PREMATURITIES MUST BE ELIMINATED
IN MAXIMUM INTERCUSPATION

14. IPO WITH PREMATURE CONTACT
ELIMINATION OF PMC WITH IMPLANT PROSTHESIS
USE 25 µm
ARTICULATING
PAPER
In occlusion light contacts
withLight tapping force

15. Following elimination of premature contacts under light
contact(harmonization under light loads)
Premature contacts are eliminated under heavy
contact(harmonization under heavy loads)
O
Elimination
This ensures equal sharing of the load between the
implant and the natural teeth under heavy loads.

16. Following premature contact adjustment
Centric
occlusion
Anterior implant
prosthesis - No
initial contact
Surrounding
natural teeth -
Greater initial
contact.
Posterior
Implant
prosthesis -
Minimum initial
contact

17. Regular evaluation of occlusal contacts at regularly
scheduled hygiene appointments so that minor variations
occurring during long-term functioning can be monitored
An important philosophy behind ipo

18. IMPLANT PROTECTIVE OCCLUSION
REDUCE FORCE
MAGNIFICATION
IMPROVE FORCE
DIRECTION
INCREASE SUPPORT
AREA
1.Premature Contact
Elimination
2.Occlusal Contact
Position
3.Cantilever Prosthesis
4.Crown Height
5.Crown Contour
6.Parafunction
7.Favouring weak arch
8.Occlusal material
1.Implant Angle
2.Cusp Angle
3.Mutually Protected
Occlusion
4.Occlusal Table Width
1.Loading Time
2.Adequate Surface
Area (implant
number, width &
length)

19. IPO AND OCCLUSAL CONTACT

20. PRIMARY
CONTACT
SECONDARY
CONTACT
Ideal occlusal contact for implant prosthesis is over the implant body
WITH IN THE
IMPLANT
DIAMETER,WITH IN
CENTRAL FOSSA
WITHIN 1 mm
OF PERIPHERY
OF IMPLANT
POSTERIORTOOTH

21. Influence of Occlusal Contacts

22. 26
REDUCE FORCE
MAGNIFICATION
IMPROVE FORCE
DIRECTION
INCREASE SUPPORT
AREA
1.Premature Contact
Elimination
2.Occlusal Contact
Position
3.Cantilever
Prosthesis
4.Crown Height
5.Crown Contour
6.Parafunction
7.Favouring weak
arch
8.Occlusal material
1.Implant Angle
2.Cusp Angle
3.Mutually
Protected Occlusion
4.Occlusal Table
Width
1.Loading Time
2.Adequate Surface
Area (implant
number, width &
length)
Implant protective Occlusion

23. IPO AND CANTILEVER PROSTHESIS
GOAL SHOULD BE TO REDUCE THE
LENGTH OF CANTILEVER
CANTILEVERS ARE CLASS I LEVER
WHICH INCREASES THE AMOUNT
OF STRESS ON THE IMPLANT

24. 28
Cantilever

25. ACTS AS
IPO and CANTILEVER
COMPRESSIVE
LOAD ON
CANTILEVER
TENSILE LOAD ON
FARTHEST
ABUTMENT
y
X
LOAD ON THE
NEAREST
ABUTMENT ISA
COMBINATION
X+Y
SEVERE LOSS OF
CRESTAL BONE

26. IPO and CANTILEVER
LENGTH OF THE
CANTILEVER
FORCE ON THE IMPLANT
DIRECTLY PROPORTIONAL
Maxillary anteriors
Maxillary posteriors
-10 mm
-15 mm
Mandibular posteriors -20mm
MAXIMUM LENGTH OF CANTILEVER FOR SYSTEMS WITH 4-6 IMPLANTS
NO LATERAL LOADS TO CANTILEVER PORTION
Gradient of force type load that gradually decreases the occlusal contact force along
the cantilever.

27. 31
IMPLANT PROTECTIVE OCCLUSION
REDUCE FORCE
MAGNIFICATION
IMPROVE FORCE
DIRECTION
INCREASE SUPPORT
AREA
1.Premature Contact
Elimination
2.Occlusal Contact
Position
3.Cantilever Prosthesis
4.Crown Height
5.Crown Contour
6.Parafunction
7.Favouring weak arch
8.Occlusal material
1.Implant Angle
2.Cusp Angle
3.Mutually Protected
Occlusion
4.Occlusal Table
Width
1.Loading Time
2.Adequate Surface
Area (implant
number, width &
length)

28. IPO AND CROWN HEIGHT
CROWN HEIGHT IS
DETERMINED ATTHE TIME OF
DIAGNOSIS
REDUCE CROWN TO IMPLANT
RATIO
TO REDUCE CANTILEVER

29. • Increased crown height acts as Vertical cantilever -
(magnifies stress)
• During lateral load,angled force,cantilever load and
results in greater force component.
IPO AND CROWN HEIGHT

30. 34
REDUCE FORCE
MAGNIFICATION
IMPROVE FORCE
DIRECTION
INCREASE SUPPORT
AREA
1.Premature Contact
Elimination
2.Occlusal Contact
Position
3.Cantilever Prosthesis
4.Crown Height
5.Crown Contour
6.Parafunction
7.Favouring weak arch
8.Occlusal material
1.Implant Angle
2.Cusp Angle
3.Mutually Protected
Occlusion
4.Occlusal Table Width
1.Loading Time
2.Adequate Surface
Area (implant
number, width &
length)
IMPLANT PROTECTIVE OCCLUSION
OCCLUSION

31. 36
IPO AND CROWN CONTOUR

32. 35
DUE TO RRR
IPO AND CROWN CONTOUR
OCCLUSION
NARROW OCCLUSAL TABLE
with reduced buccal contour,
IMPROVING AXIAL
LOADING
Buccal contour
the same as the original,
natural tooth will lead to
buccal offset load
Remaining ridge shifts
lingually
Implant body under the
lingual cusp of a natural
tooth( not under the
natural buccal cusp tip)

33. 37
IPO and Crown Contour
Central fossa of
Implant crown
broadened 2-3
mm to receive
functional cusp
contact from
natural teeth
DIVISION A BONE

34. 38
IPO and Crown Contour
DIVISION A BONE
Axial loading in both arches
not possible so favour the
weaker maxilla

35. 39
IPO and Crown Contour
Division C and D bone, bone augmentation procedure and create a condition as close
as possible to Division B bone.
Mandibular
posterior
implants require
angulated
abutment
DIVISION B ,C & D
BONE
Maxillary
posterior
implants require
restoration in
crossbite
The implant position
lingual to the
position of the
natural tooth.

36. 40
REDUCE FORCE
MAGNIFICATION
IMPROVE FORCE
DIRECTION
INCREASE SUPPORT
AREA
1.Premature Contact
Elimination
2.Occlusal Contact
Position
3.Cantilever Prosthesis
4.Crown Height
5.Crown Contour
6.Parafunction
7.Favouring weak arch
8.Occlusal material
1.Implant Angle
2.Cusp Angle
3.Mutually Protected
Occlusion 4.Occlusal
Table Width
1.Loading Time
2.Adequate Surface
Area (implant
number, width &
length)
IMPLANT PROTECTIVE OCCLUSION

37. IPO AND PARAFUNCTION
POOR OCCLUSAL
DESIGN
BRUXISM
PARAFUNCTION
CLENCHING
Marginal bone loss and implant failure

38. By using maximum fixture length
Shorter cantilevers
Proper location of fixtures along the arch
Ridge augmentation
Reduction in height of crown
By increasing soft tissue support
Night guard protection
IPO and Parafunction
In patients with parafunctional habits, The overload canbe greatly reduced:-

39. 43
REDUCE FORCE
MAGNIFICATION
IMPROVE FORCE
DIRECTION
INCREASE SUPPORT
AREA
1.Premature Contact
Elimination
2.Occlusal Contact
Position
3.Cantilever Prosthesis
4.Crown Height
5.Crown Contour
6.Parafunction
7.Favouring weak arch
8.Occlusal material
1.Implant Angle
2.Cusp Angle
3.Mutually Protected
Occlusion
4.Occlusal Table
Width
1.Loading Time
2.Adequate Surface
Area (implant
number, width &
length)
IMPLANT PROTECTIVE OCCLUSION

40. DESIGN OF
PROSTHESIS
WEAKESTARCH
SHOULD ALWAYS FAVOUR
MAXILLA
IPO AND WEAK ARCH FAVOURING
COMPROMISED
ANATOMICAL
CONDITIONS
1. NARROW IMPLANTS
2. NARROW RIDGES
3. REDUCED BONE DENSITY
4. INCREASED BONE
RESORPTION
5. FACIAL CANTILEVER

41. IPO and Arch Strength
PREMAXILLA
SO CHOOSE ANGLED ABUTMENT IN PREMAXILLA
STRAIN IS
HIGHER
STRAIN IS
LESSER

42. IPO and Arch Strength
RECOMMENDATIONS
USE OF MORE
NUMBER OF
IMPLANTS WITH
SPLINTING
USE OF LARGER
DIAMETER
IMPLANTS WITH
RIDGE
AUGMENTATION

43. Favouring weak arch
MAXILLARY POSTERIOR CANTILEVERS ARE LESS INDICATED
IF THE IMPLANTS OF THE BOTH ARCHES CANNOT BE LOADED
TOGETHER ,MAXILLARY IMPLANTS ARE PROTECTED WITH AXIAL
LOAD

44. 47
REDUCE FORCE
MAGNIFICATION
IMPROVE FORCE
DIRECTION
INCREASE SUPPORT
AREA
1.Premature Contact
Elimination
2.Occlusal Contact
Position
3.Cantilever Prosthesis
4.Crown Height
5.Crown Contour
6.Parafunction
7.Favouring weak arch
8.Occlusal material
1.Implant Angle
2.Cusp Angle
3.Mutually Protected
Occlusion
4.Occlusal Table
Width
1.Loading Time
2.Adequate Surface
Area (implant
number, width &
length)
IMPLANT PROTECTIVE OCCLUSION

45. IPO AND OCCLUSAL MATERIAL
DEPENDS ON
CHOICE OF
OCCLUSAL
MATERIAL
FOR
IMPLANT
PROSTHESIS
QUADRANT RESTORED

46. 1. ALL CERAMIC
2. ZIRCONIA
3. METALCERAMIC
RESTORATIONS
4. ALL METAL
5. RESIN BASED
6. ACRYLIC
u
OCCLUSAL MATERIAL EVALUATED
BY
OCCLUSAL MATERIAL
Occlusal material fracture is one of the most common
of implant restoration
1. ESTHETIC
2. IMPACT FORCE
3. STATIC LOAD
4. CHEWING EFFICIENCY
5. FRACTURE
6. WEAR
7. INTERARCH SPACE
REQUIREMENT
8. ACCURACY OF CASTING

47. 50
REDUCE FORCE
MAGNIFICATION
IMPROVE FORCE
DIRECTION
INCREASE SUPPORT
AREA
1.Premature Contact
Elimination
2.Occlusal Contact
Position
3.Cantilever Prosthesis
4.Crown Height
5.Crown Contour
6.Parafunction
7.Favouring weak arch
8.Occlusal material
1.Implant Angle
2.Cusp Angle
3.Mutually Protected
Occlusion 4.Occlusal
Table Width
1.Loading Time
2.Adequate Surface
Area (implant
number, width &
length)
IMPLANT PROTECTIVE OCCLUSION

48. IPO AND IMPLANT ANGLE / LOAD DIRECTION
CONDITIONS OF ANGLED LOAD
DIRECTION
ANGLED
IMPLANT
BODIES
ANGLED
ABUTMENTS
PREMATURE
OCCLUSAL
CONTACT

49. Angled load---Angled implant
15° angled implant---30% offset load to facial bone.
30° angled implant—50% increase of stress at crestal bone.

50. ANGLED LOAD
APPLIED
CAUSES
SHEAR COMPONENT OF
LOAD
CRESTAL BONE LOSS AND
INTERFERES WITH
SUCCESSFUL BONE
REGROWTH
IMPLANT BODY

51. ANISOTROPY refers to CHARACTER
OF BONE
MECHANICAL PROPERTIES
DEPEND ON THE DIRECTION
IN WHICH THE BONE IS
LOADED
ANGLE OFLOAD
SHEAR
COMPONENT OF
LOAD

52. CORTICALBONE
WITHSTAND
Angled load
SHEAR(65%LESS)
AND
TENSILE(30%LESS)
FORCE
COMPRESSIVE
FORCE

53. TO PREVENT
CAUSES
O
Angled loads
WHENEVR
ANGLED LOADS
CANNOT BE
ELIMINATED
BONE LOSS OR
IMPLANT LOSS
REDUCE
MAGNITUDE OF
FORCE
INCREASE
SURFACE
AREA

54. Solution to Angled loads
INCREASING DIAMETER OF
ANGLED IMPLANT
USING MORE NUMBER OF
IMPLANTS
SELECTING A DESIGN WITH
GREATER SURFACE AREA
ADDITIONAL IMPLANT NEXT TO
THE MOST ANGLED IMPLANT
SPLINTING
THESE CAN BE ACHIEVED BY

55. 57
IMPLANT PROTECTIVE OCCLUSION
REDUCE FORCE
MAGNIFICATION
IMPROVE FORCE
DIRECTION
INCREASE SUPPORT
AREA
1.Premature Contact
Elimination
2.Occlusal Contact
Position
3.Cantilever Prosthesis
4.Crown Height
5.Crown Contour
6.Parafunction
7.Favouring weak arch
8.Occlusal material
1.Implant Angle
2.Cusp Angle
3.Mutually Protected
Occlusion 4.Occlusal
Table Width
1.Loading Time
2.Adequate Surface
Area (implant
number, width &
length)

56. ANGLED
LOAD ON
IMPLANTS
ANGLED
LOAD
CRESTAL
BONE
LOSS
IPO AND CUSPAL ANGLE
CUSPAL
ANGLE

57. GREATER
CUSPAL ANGLE
EFFICIENT
INCISION OF
FOOD
BUT PREMATURE OCCLUSAL CONTACT ALONG
CUSP ANGLE COULD RESULT IN ANGLEDLOAD
ON THE CRESTAL BONE
KAUKINEN etal
CUSPAL ANGLE

58. For every 10° increase in cusp inclination----30%
increase in torque
Cusp inclination produce a
high level of torque.
IMPLANT RETAINED
PROSTHESIS SHOULD
HAVE SHALLOW
OCCLUSALANATOMY
Solution no:1

59. Occlusal contact on implant crown
should be on flat surface
perpendicular to implant body
• Increasing width of
central groove in posterior
implant crown(2-3mm)
• Recontouring opposing tooth to
occlude in central fossa over
Implant body
SOLUTION.2
Accomplished by

60. 62
IMPLANT PROTECTIVE OCCLUSION
REDUCE FORCE
MAGNIFICATION
IMPROVE FORCE
DIRECTION
INCREASE SUPPORT
AREA
1.Premature Contact
Elimination
2.Occlusal Contact
Position
3.Cantilever Prosthesis
4.Crown Height
5.Crown Contour
6.Parafunction
7.Favouring weak arch
8.Occlusal material
1.Implant Angle
2.Cusp Angle
3.Mutually Protected
Occlusion
4.Occlusal Table
Width
1.Loading Time
2.Adequate Surface
Area (implant
number, width &
length)

61. Rationale of MPO
The forces are distributed to
segments of the jaws
Decrease in force magnitudes
IPO AND MUTUALLY PROTECTED OCCLUSION
CANINE PROTECTIVE OR ORGANIC OCCLUSION.

62. 64
OR MAY HAVE
LIGHT CONTACT
FIXED IMPLANT PROSTHESIS
Posteriors
contact and
anteriors
disocclude
CENTRIC

63. Protrusive
excursions
Incisors contact,
posteriors and
canine
disocclude

64. Lateral
Excursions
Canine
contact,
incisors and
posteriors
disocclude

65. Anterior guidance of implant prosthesis with anterior implants
SHOULD
Anterior guidance of
implant prosthesis with
anterior implants
AS SHALLOWAS
POSSIBLE
STEEPER THE
ANTERIOR
GUIDANCE
GREATER THE
FORCE ON
ANTERIOR
IMPLANTS
• In most patients ,an
incisal guidance of atleast
23-25° is suggested in
IPO.
• Vertical overbite reduced
to less than 4mm

66. IF CANINE IS
REPLACED BY
IMPLANT
Occlusal contact
over this must
be avoided
during
excursion
IFANTERIOR
IMPLANTS MUST
DISOCCLUDE
THE POSTERIOR
TEETH
Implants maybe
splinted together to
reduce lateral force
MPO on Lateral incisor

67. 69
IMPLANT PROTECTIVE OCCLUSION
REDUCE FORCE
MAGNIFICATION
IMPROVE FORCE
DIRECTION
INCREASE SUPPORT
AREA
1.Premature Contact
Elimination
2.Occlusal Contact
Position
3.Cantilever Prosthesis
4.Crown Height
5.Crown Contour
6.Parafunction
7.Favouring weak arch
8.Occlusal material
1.Implant Angle
2.Cusp Angle
3.Mutually Protected
Occlusion
4.Occlusal Table
Width
1.Loading Time
2.Adequate Surface
Area (implant
number, width &
length)

68. 70
• Wider the occlusal table, the greater the force developed.
• Occlusal anatomy of natural teeth often results in offset load
IPO AND OCCLUSAL TABLE WIDTH
Width of the occlusal
table
Width of the implant
body
Width of the occlusal table must be
reduced in comparison to a natural tooth
in non aesthetic regions

69. THE NARROW OCCLUSAL TABLE
THE OFFSET
LOAD
HENCE TEETH RESTORED IN NON-
ESTHETIC REGION OF THE MOUTH
PREFERABLY HAVEA NARROW
OCCLUSAL TABLE
REDUCES DECREASES
RISK OF
CERAMIC
FRACTURE
REDUCED
OCCLUSAL
LOAD
HELPS TO
MAINTAIN
THE NARROW
OCCLUSAL TABLE
NARROW
OCCLUSAL
TABLE
GREATER
HYGIENE

70. 72
IMPLANT PROTECTIVE OCCLUSION
REDUCE FORCE
MAGNIFICATION
IMPROVE FORCE
DIRECTION
INCREASE SUPPORT
AREA
1.Premature Contact
Elimination
2.Occlusal Contact
Position
3.Cantilever Prosthesis
4.Crown Height
5.Crown Contour
6.Parafunction
7.Favouring weak arch
8.Occlusal material
1.Implant Angle
2.Cusp Angle
3.Mutually Protected
Occlusion
4.Occlusal Table
Width
1.Loading Time
2.Adequate Surface
Area (implant
number, width &
length)

71. IPO AND LOADING TIME
IMPLANT
LOADING
PROGRESSIVE
DELAYED
IMMEDIATE
DENSITY OF
BONE
DETERMINES TIME OF
LOADING

72. IMMEDIATE
LOADING
ESTHETIC ZONE
OFTEN DONE
BECAUSE OF
DAMPING
EFFECT
CHOICE OF
MATERIAL
RESIN BASED

73. WOLFF'S LAW
BASED ON WHERE THE
MASS OF BONE
INCREASES IN
RESPONSE TO
CONTROLLED
STRESSES
WHEN LOAD APPLIED
TO IMPLANTS IN POOR
QUALITY BONE
INCREASED GRADUALLY
FUNCTION
MASS AND
DENSITY OF BONE
1. TIME INTERVAL(3-6 MO)
2. DIET(SOFT TO HARD)
3. OCCLUSAL MATERIAL(R-M-P)
4. OCCLUSAL CONTACT(GRADUA L INCREASE)
5. DESIGN OF PROSTHESIS
6. LESS DENSE BONE
PROGRESSIVE LOADING
PROGRESSIVE
LOADING
FACTORS

74. When Implants Are Placed And It Has Been
Decided To Place The Restoration
Osseoinegration Following A 2nd
After
Stage
Surgery, The Loading Is Defined As Delayed
Loading
DELAYED
LOADING
DELAYED LOADING
Grafted situation
Can be well done in
non-esthetic zone
Where The Quality Of
Bone Needs To Be
Improved
where the implant
stability is less than
45Ncm

75. 77
REDUCE FORCE
MAGNIFICATION
IMPROVE FORCE
DIRECTION
INCREASE SUPPORT
AREA
1.Premature Contact
Elimination
2.Occlusal Contact
Position
3.Cantilever Prosthesis
4.Crown Height
5.Crown Contour
6.Parafunction
7.Favouring weak arch
8.Occlusal material
1.Implant Angle
2.Cusp Angle
3.Mutually Protected
Occlusion
4.Occlusal Table
Width
1.Loading Time
2.Adequate Surface
Area (implant
number, width &
length)
IMPLANT PROTECTIVE OCCLUSION

76. IPO AND SURFACE AREA
Compensates for increased load
INCREASE
WIDTH OF
THE
IMPLANT
INCREASE
NUMBER OF
THE IMPLANT
SPLINTING
THE
IMPLANTS

77. • Wider diameter implants- preferred.
• Since they have a greater area of bone contact at the
crest than a narrow implants, For a given occlusal
load - stress at the crestal region is lesser when
compared to narrow implants
• Larger the S.A wider the distribution of force.
• Lesser the concentration of force on the crest.
Surface area

78. • .
Multiple implants must be staggered not placed in
straight line

79. •If a 3 unit fixed prosthesis
supported by 2 implants is
cantilevered, stress is
doubled.
2000)
•If a 3 unit F.P.D is
supported by 3 implants
stress is reduced to 1/3rd .
Splinted larger diameter of
implants decrease crestal load
more Effectively(Sato Y ,et.al,
Surface area

81. 8
4
Kim Y, Oh T-J, Misch CE, Wang

82. OPPOSING ARCH TYPE OF OCCLUSION EXTRA CARE
COMPLETE DENTURE BALANCED OCCLUSION
NATURAL DENTITION MUTUALLY
PROTECTIVE/GROUP FN
OCCLUSION SHALLOW ANTERIOR
GUIDANCE
FIXED MUTUALLY
PROTECTIVE/GROUP FN
OCCLUSION
IN CANTILEVERS  NO WORKING AND
BALANCING
CONTACTS.
 INFRA OCCLUDE BY
100UM
 FREEDOM IN
CENTRIC 1-1.5MM
FULL ARCH FIXED IMPLANT PROSTHESIS

83. 86
OVER DENTURE
Bilateral balanced occlusion using
lingualized occlusion
Monoplane occlusion on a
severely resorbed ridge

84. POSTERIOR IMPLANT SUPPORTED FIXED PROSTHESIS
OCCLUSAL
TABLE
NARROW
FLAT
CUSPS
MINIMUM
OR NO
CANTILEVER
1. Anterior guidance with natural dentition.
2. Group function occlusion with
compromised canines.
Contacts should be centered over the implant body

85. 88
SINGLE IMPLANT PROSTHESIS
1.Anterior Or Lateral Guidance With Natural
Dentition
2.Light Contact At Heavy Bite And No
Contact At Light Bite
INCREASED
PROXIMAL
CONTACT
NO OFFSET
CONTACTS
CENTERED
CONTACTS
(1–1.5MM
FLATAREA)

86. REVIEW OF LITERATURE

87. Review of literature
Taylor ,Weins,Carr.Evidence based considerations for removable prosthodontic
and dental implant occlusion:A Literature review.The journal of prosthetic
dentistry.Dec 2005.Vol.94(6)
• The effect of non- axial load on implant function and survival.
Two studies:
One in a primate model with cyclic occlusal loading
Sheep with static loading
Conclusion: They were unable to demonstrate a negative effect on bone to implant
anchorage after extended periods of non-axial loading.
• Progressive loading and occlusal overload of dental implants.
The evidence available doesnot support the need for progressive loading.
The effect of placing restorations on a previously unloaded implants in heavier than
normal occlusion. The occlusal overload was tolerated by implants without any deleterious
effects.

88. Review of literature
Proprioception and Dental implants:
• The patients with extensive implant supported prosthesis clinically function well
without the benefit of periodontal proprioceptive nerve endings.
• The presence of proprioceptive nerve endings in periosteum ,muscles of
mastication ,oral mucosa,TMJ compensate for those lost from the missing
periodontal ligament.
osseoperception

89. PREDOMINANTLY
A PROSTHETIC
DISCIPLINE
IMPLANT
TREATMENT
COMPLETE AWARENESS OF THE FINAL OUTCOME OF THE
PROSTHESIS MUST BE PRESENT PRIOR TO IMPLANT
PLACEMENT
CONCLUSION

90. • Occlusion has been an important variable in the success or failure
of most prosthodontic reconstructions.
• With natural teeth, a certain degree of flexibility permits
compensation for any occlusal irregularities.
• Implant dentistry is not as forgiving.
• The status of the occlusion must be diagnosed, corrected or compensated and
properly integrated into the design of the definitive restoration.

91. 1.Dental Implant Prosthetics – Carl.E.Misch
2.Principles Of Occlusion In Implant Dentistry Mahesh Verma, Aditi Nanda, Abhinav
Sood 2015 Journal Of The International Clinical Dental Research Organization |
Published By Wolters Kluwer – Medknow
3.Implant Protected Occlusion Yogeshwari Swaminathan¹, Gururaj Rao²iosr Journal
Of Dental And Medical Sciences (Iosr-jdms)volume 11, Issue 3 (Nov.- Dec. 2013), Pp
20-25
4.Occlusal Considerations In Implant Therapy: Clinical Guidelines With
Biomechanical
Rationale Kim Y, Oh T-j, Misch Ce, Wang H-l. Occlusal Considerations In Implant
Therapy: Clinical Guidelines With Biomechanical Rationale. Clin. Oral Impl. Res. 16,
2005; 26–35
5.Implant Occlusion: Biomechanical Considerations Forimplant-supported
Prostheses Yu-ying Chen1,2 Chung-ling Kuan1 Yi-bing Wang1,2 J Dent Sci 2008‧vol
3‧no 2
REFERENCES

92. THANKYOU