Does traumatic occlusal forces lead to peri-implant bone loss? A systematic review

Abstract

Observational studies have indicated that crestal bone level changes at implants are typically associated with clinical signs of inflammation, but still mechanical overload has been described as possible factor leading to hard-tissue deficiencies at implant sites without mucosal inflammation. The aim of this paper was systematically review the literature regarding the possible effect of traumatic occlusal forces on the peri-implant bone levels. Literature search was conducted using PubMed, Scielo and Lilacs, including the following terms: oral OR dental AND implant$ AND (load OR overload OR excessive load OR force$ OR bruxism) AND (bone loss OR bone resorption OR implant failure$). Databases were searched for the past 10 years of publications, including: clinical human studies, either randomized or not, cohort studies, case control studies, case series and animal research. Exclusion criteria were review articles, guidelines and in vitro and in silico (finite element analysis) research, as well as retrospective studies. The PICO questions formulated was: "does traumatic occlusal forces lead to peri-implant bone loss?" The database searches as well as additional hand searching, resulted in 807 potentially relevant titles. After inclusion/exclusion criteria assessment 2 clinical and 4 animal studies were considered relevant to the topic. The included animal studies did not reveal an association between overload and peri-implant bone loss when lower overloads were applied, whereas in the presence of excessive overload it seemed to generate peri-implant bone loss, even in the absence of inflammation. The effect of traumatic occlusal forces in peri-implant bone loss is poorly reported and provides little evidence to support a cause-and-effect relationship in humans, considering the strength of a clinically relevant traumatic occlusal force.

A Comparison of Biomechanical Properties of Implant-Retained Overdenture Based on Precision Attachment Type

“…This is where a marked increase in stress was noted. It seems, therefore, that the risk of loosening or even damage to these elements is greater than the disintegration of the implant or peri-implantitis [ 40 , 41 ]. The conducted research confirmed the reports of other authors that the greatest load occurs in the distal parts of the bar retention [ 42 , 43 ].…”

Different Treatment Modalities Using Dental Implants in the Posterior Maxilla: A Finite Element Analysis

“…Occlusal overloading has been reported as the main responsible for bone loss, which also contributes for the high prosthetic failures rates suggesting that excessive loading is more harmful (1,9,30). For this reason, the load used in the study was an axial force in order to create a physiological environment and isolate that influence of treatment modalities in the bone tissue biomechanics.…”

Prevalence and risk indicators for peri-implant diseases: A literature review

“…Few clinical papers have shown a correlation between overload and peri-implant inflammation, and no direct link has been found in animal studies [ 59 ]. However, excessive occlusal force may cause implant fracture [ 60 ], resulting in rapid bone resorption around the implant.…”