J Periodontal Implant Sci.  2016 Dec;46(6):396-404. 10.5051/jpis.2016.46.6.396.

Association between dental implants in the posterior region and traumatic occlusion in the adjacent premolars: a long-term follow-up clinical and radiographic analysis

• Lee JH
• Kweon HH
• Choi SH
• Kim YT

• KMID: 2362905
• DOI: http://doi.org/10.5051/jpis.2016.46.6.396

Abstract

PURPOSE
The aim of this retrospective study was to determine the association between dental implants in the posterior region and traumatic occlusion in the adjacent premolars, using data collected during from 2002 to 2015.
METHODS
Traumatic occlusion in the adjacent premolars was assessed by examining clinical parameters (bleeding on probing, probing pocket depth, fremitus, and tooth mobility) and radiographic parameters (loss of supporting bone and widening of the periodontal ligament space) over a mean follow-up of 5 years. Clinical factors (gender, age, implant type, maxillary or mandibular position, opposing teeth, and duration of functional loading) were evaluated statistically in order to characterize the relationship between implants in the posterior region and traumatic occlusion in the adjacent premolars.
RESULTS
The study inclusion criteria were met by 283 patients, who had received 347 implants in the posterior region. The incidence of traumatic occlusion in the adjacent premolars was significantly higher for splinted implants (P=0.004), implants in the maxillary region (P<0.001), and when implants were present in the opposing teeth (P<0.001). The other clinical factors of gender, age, and duration of functional loading were not significantly associated with traumatic occlusion.
CONCLUSIONS
This study found that the risk of traumatic occlusion in the adjacent premolars increased when splinted implants were placed in the maxillary molar region and when the teeth opposing an implant also contained implants.

Keyword

Bicuspid; Dental implants; Single-tooth dental implants; Tooth mobility

MeSH Terms

Bicuspid*
Dental Implants*
Dental Implants, Single-Tooth
Follow-Up Studies*
Humans
Incidence
Molar
Periodontal Ligament
Retrospective Studies
Splints
Tooth
Tooth Mobility
Dental Implants

Figure

• 

  Figure 1 Radiograph of splinted dental implants in the maxillary posterior region and adjacent natural premolar tooth. The maxillary right second premolar is characterized by widening of the PDL space around the root surface (arrows) and an intact marginal bone level. PDL, periodontal ligament.

• 

  Figure 2 Severity of tooth mobility according to adjacent premolar position. Tooth mobility was evaluated and classified using Miller's classification. Mob, mobility; Mn., mandibular; Mx., maxillary.

• 

  Figure 3 Incidence of traumatic occlusion in the adjacent premolar region according to the duration of functional loading. Mn., mandibular; Mx., maxillary.

Reference

1. Schulte W. Implants and the periodontium. Int Dent J. 1995; 45:16–26.

2. Berglundh T, Abrahamsson I, Welander M, Lang NP, Lindhe J. Morphogenesis of the peri-implant mucosa: an experimental study in dogs. Clin Oral Implants Res. 2007; 18:1–8.

3. Yuan JC, Sukotjo C. Occlusion for implant-supported fixed dental prostheses in partially edentulous patients: a literature review and current concepts. J Periodontal Implant Sci. 2013; 43:51–57.

4. Koyano K, Esaki D. Occlusion on oral implants: current clinical guidelines. J Oral Rehabil. 2015; 42:153–161.

5. Lewis MB, Klineberg I. Prosthodontic considerations designed to optimize outcomes for single-tooth implants. A review of the literature. Aust Dent J. 2011; 56:181–192.

6. Klineberg I, Kingston D, Murray G. The bases for using a particular occlusal design in tooth and implant-borne reconstructions and complete dentures. Clin Oral Implants Res. 2007; 18:Suppl 3. 151–167.

7. Weinberg LA. Reduction of implant loading with therapeutic biomechanics. Implant Dent. 1998; 7:277–285.

8. Morneburg TR, Pröschel PA. In vivo forces on implants influenced by occlusal scheme and food consistency. Int J Prosthodont. 2003; 16:481–486.

9. Kim Y, Oh TJ, Misch CE, Wang HL. Occlusal considerations in implant therapy: clinical guidelines with biomechanical rationale. Clin Oral Implants Res. 2005; 16:26–35.

10. Craddock HL, Youngson CC, Manogue M, Blance A. Occlusal changes following posterior tooth loss in adults. Part 1: a study of clinical parameters associated with the extent and type of supraeruption in unopposed posterior teeth. J Prosthodont. 2007; 16:485–494.

11. Craddock HL, Youngson CC, Manogue M, Blance A. Occlusal changes following posterior tooth loss in adults. Part 2. Clinical parameters associated with movement of teeth adjacent to the site of posterior tooth loss. J Prosthodont. 2007; 16:495–501.

12. Craddock HL. Occlusal changes following posterior tooth loss in adults. Part 3. A study of clinical parameters associated with the presence of occlusal interferences following posterior tooth loss. J Prosthodont. 2008; 17:25–30.

13. Powell LV. Caries prediction: a review of the literature. Community Dent Oral Epidemiol. 1998; 26:361–371.

14. Liu S, Liu Y, Xu J, Rong Q, Pan S. Influence of occlusal contact and cusp inclination on the biomechanical character of a maxillary premolar: a finite element analysis. J Prosthet Dent. 2014; 112:1238–1245.

15. Torbjörner A, Fransson B. Biomechanical aspects of prosthetic treatment of structurally compromised teeth. Int J Prosthodont. 2004; 17:135–141.

16. Hallmon WW, Harrel SK. Occlusal analysis, diagnosis and management in the practice of periodontics. Periodontol 2000. 2004; 34:151–164.

17. Misch CE, Bidez MW. Implant-protected occlusion: a biomechanical rationale. Compendium. 1994; 15:1330.

18. Pihlstrom BL, Anderson KA, Aeppli D, Schaffer EM. Association between signs of trauma from occlusion and periodontitis. J Periodontol. 1986; 57:1–6.

19. Alkan A, Keskiner I, Arici S, Sato S. The effect of periodontal surgery on bite force, occlusal contact area and bite pressure. J Am Dent Assoc. 2006; 137:978–983.

20. Heitz-Mayfield LJ, Schmid B, Weigel C, Gerber S, Bosshardt DD, Jönsson J, et al. Does excessive occlusal load affect osseointegration? An experimental study in the dog. Clin Oral Implants Res. 2004; 15:259–268.

21. Gotfredsen K, Berglundh T, Lindhe J. Bone reactions adjacent to titanium implants subjected to static load of different duration. A study in the dog (III). Clin Oral Implants Res. 2001; 12:552–558.

22. Wiskott HW, Cugnoni J, Scherrer SS, Ammann P, Botsis J, Belser UC. Bone reactions to controlled loading of endosseous implants: a pilot study. Clin Oral Implants Res. 2008; 19:1093–1102.

23. Okada T, Ikebe K, Inomata C, Takeshita H, Uota M, Mihara Y, et al. Association of periodontal status with occlusal force and food acceptability in 70-year-old adults: from SONIC Study. J Oral Rehabil. 2014; 41:912–919.

24. Norton MR, Gamble C. Bone classification: an objective scale of bone density using the computerized tomography scan. Clin Oral Implants Res. 2001; 12:79–84.

25. Ishigaki S, Kurozumi T, Morishige E, Yatani H. Occlusal interference during mastication can cause pathological tooth mobility. J Periodontal Res. 2006; 41:189–192.

26. Park HS, Lee YJ, Jeong SH, Kwon TG. Density of the alveolar and basal bones of the maxilla and the mandible. Am J Orthod Dentofacial Orthop. 2008; 133:30–37.

27. Jung RE, Zembic A, Pjetursson BE, Zwahlen M, Thoma DS. Systematic review of the survival rate and the incidence of biological, technical, and aesthetic complications of single crowns on implants reported in longitudinal studies with a mean follow-up of 5 years. Clin Oral Implants Res. 2012; 23:Suppl 6. 2–21.

28. Hermanides L. Criteria to manage the technical and biologic success of an implant abutment. Compend Contin Educ Dent. 2014; 35:463–468.

29. Albrektsson T, Donos N. Working Group 1. Implant survival and complications. The third EAO consensus conference 2012. Clin Oral Implants Res. 2012; 23:Suppl 6. 63–65.

30. Falcón-Antenucci RM, Pellizzer EP, de Carvalho PS, Goiato MC, Noritomi PY. Influence of cusp inclination on stress distribution in implant-supported prostheses. A three-dimensional finite element analysis. J Prosthodont. 2010; 19:381–386.

31. Hsu YT, Fu JH, Al-Hezaimi K, Wang HL. Biomechanical implant treatment complications: a systematic review of clinical studies of implants with at least 1 year of functional loading. Int J Oral Maxillofac Implants. 2012; 27:894–904.

32. Bhatnagar VM, Karani JT, Khanna A, Badwaik P, Pai A. Osseoperception: an implant mediated sensory motor control- a review. J Clin Diagn Res. 2015; 9:ZE18–20.

33. Sutter F, Weingart D, Mundwiler U, Sutter FJ, Asikainen P. ITI implants in combination with bone grafts: design and biomechanical aspects. Clin Oral Implants Res. 1994; 5:164–172.

34. Jacobs R, Van Steenberghe D. From osseoperception to implant-mediated sensory-motor interactions and related clinical implications. J Oral Rehabil. 2006; 33:282–292.

35. Norton MR. Assessment of cold welding properties of the internal conical interface of two commercially available implant systems. J Prosthet Dent. 1999; 81:159–166.