Occlusal Concepts Application in Resolving Implant Prosthetic Failure: Case Report

Abstract

The prosthetic management of a poor implant treatment is presented in this case report. The recommended occlusion concepts for implant-supported prostheses were applied for the resolution of the case. The rehabilitation of the posterior segments provided a mutually protected occlusion with adequate distribution of the axial and lateral bite forces with stable posterior occlusion. The clinical exam indicated the need for modification in the vertical dimension of occlusion. Sufficient interocclusal rest space was present to test the alteration in the vertical dimension. The aim was to achieve an occlusion scheme that followed four specific criteria: (1) centric contacts and centric relation of the jaw-to-jaw position; (2) anterior guidance only; (3) shallow anterior angle of tooth contact; and (4) vertical dimension of occlusion with acceptable tooth form and guidance. The success of an oral rehabilitation relies in following the aforementioned criteria, appropriate interaction between the dental laboratory technician and the clinician, careful elaboration of the provisional rehabilitation with all the desired details to be reproduced in the final prosthetic restoration and sufficient follow-up time of the provisional prostheses before placing the final restoration.

Loosening of the fixing screw in single implant crowns: predisposing factors, prevention and treatment options

“…Jeamcoski et al suggested centric contacts, anterior guidance, shallow anterior angle of tooth contact and vertical dimension of occlusion with acceptable tooth form and guidance. The success of an oral rehabilitation relies in following the aforementioned criteria, appropriate interaction between the dental laboratory technician and the clinician, careful elaboration of the provisional rehabilitation with all the desired details to be reproduced in the final prosthetic restoration and sufficient follow‐up time of the provisional prostheses before placing the final restoration …”

A 3-year prospective cohort study on mandibular anterior cantilever restorations associated with screw-retained implant-supported prosthesis: An in vivo study

“…Wide freedom of centric was provided with shallow anterior angle and anterior guidance with evenly distributed contacts. [ 30 31 ] However, the second most common prosthetic complication observed in the present study was porcelain veneer fracture (14.3%), which is quite high and was noted very early at 06 months recall.…”

“…Bisque trail and occlusal adjustment were made to minimize occlusal stresses on the ISCP, with no incisal contact in the centric position, shallow anterior angle providing wide freedom in centric relation, anterior guidance with evenly distributed contacts. [ 30 31 ] After glazing, the finished prosthesis was screw retained using an abutment screw, tightening it to a torque of 30 Ncm (recommended torque by the manufacturer sufficient to elongate and produce tension/preload within the screw joint) using a torque wrench (Adin Dental Implant Systems Ltd., Israel) on the lower anterior implant through a lingually placed access hole. The gingival one-third of the access channel was packed with gutta-percha (Dentsply India Pvt.…”

“…[ 29 ] To reduce the occlusal overload and implant prosthetic failure, centric contacts, anterior guidance, and shallow anterior angle was suggested by Jamcoski et al . [ 30 ] Sheridan et al . recommended a mutually protected occlusion with anterior guidance and evenly distributed contacts with wide freedom in centric relation.…”