%0 Journal Article
%T Clinical Management of Implant Prostheses in Patients with Bruxism
%A Osamu Komiyama
%A Frank Lobbezoo
%A Antoon De Laat
%A Takashi Iida
%A Tsuyoshi Kitagawa
%A Hiroshi Murakami
%A Takao Kato
%A Misao Kawara
%J International Journal of Biomaterials
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/369063
%X There is general agreement that excessive stress to the bone-implant interface may result in implant overload and failure. Early failure of the implant due to excessive loading occurs shortly after uncovering the implant. Excess load on a final restoration after successful implant integration can result in physical failure of the implant structure. Many clinicians believe that overload of dental implants is a risk factor for vertical peri-implant bone loss and/or may be detrimental for the suprastructure in implant prostheses. It has been documented that occlusal parafunction, such as, bruxism (tooth grinding and clenching) affects the outcome of implant prostheses, but there is no evidence for a causal relation between the failures and overload of dental implants. In spite of this lack of evidence, often metal restorations are preferred instead of porcelain for patients in whom bruxism is presumed on the basis of tooth wear. The purpose of this paper is to discuss the importance of the occlusal scheme used in implant restorations for implant longevity and to suggest a clinical approach and occlusal materials for implant prostheses in order to prevent complications related to bruxism. 1. Introduction The most important factor in implant longevity as a factor for clinically successful implant treatment is the formation of a direct interface between the implant and the bone, without intervening soft tissue, a process called ˇ°osseointegrationˇ±. Osseointegrated dental implants represent an advance in modern odontology, which has become a great option for the rehabilitation of missing single teeth in partially or totally edentulous patients. Despite the very high success rates [1], complications associated with implant treatment may occur. Early loading failure may affect 2% to 6% of implants, and as many as 15% of restorations fail as a result of this problem [2, 3]. Excess load on a final restoration after successful implant integration can result in failure of the implant itself [4]. Therefore, it is important to clarify the risk factors for failure of implant prostheses in order to further improve the good success rate. The consequences of overload of dental implants can be divided into two groups: biological and biomechanical complications [5]. Biological complications can be divided into early failures and late failures [6]. In case of early failures, osseointegration was insufficient: the implant is lost before the first prosthetic loading. Late biological failures are characterized by pathological bone loss after full osseointegration was obtained at
%U http://www.hindawi.com/journals/ijbm/2012/369063/