1. IMPLANT OCCLUSION Sulieman Al-Johany BDS, MSD Diplomate, American Board of Prosthodontics June 25, 2009 College of Dentistry King Saud University

2. Is implant differ?

3. Vertical Movement  Initial vertical tooth movement→ 28 µm  Immediate rebound → 7 µm (4 hours for full recovery) Muhlemann HR. Tooth mobility: a review of clinical aspects and research findings. J Periodont 1967,38:686-708  Implant vertical movement → 2-3 µm 10 µm Sekine H et al. Mobility characteristics and tactile sensitivity of osseointegrated fixture- supporting systems. In van Steenberghe D, editor: Tissue integration in oral maxillofacial reconstruction, Amsterdam, 1986, Elsiver

4. Horizontal Movement  Natural teeth: 56-108 µm Parfitt GS. Measurement of the physiologic mobility of Individual teeth in an axial Direction. J Dent Res 1960,39:608-12

5. Implant: 12- 66 µm Sekine et al. 1986 40 to 115 µm in M-D direction 11 to 66 µm in B-L direction Komiyama Y. Clinical and research experience with osseointegrated implants in Japan.In Albrektsson T, Zarb G, editor: The Branemark osseointegrated implant, Chicago,1989, Quintessence  Rangert and Colleagues suggested that part of this movement may be due to component flexure Rangert B et al. Vertical load distribution on a three-unit prosthesis supported by a natural tooth and a single Branemark implant: an in vivo study. Clin Oral Implants Res 1995,6:40-6

6. Crestal bone loss around implant  Occlusal overload on implant may increase the incidence of marginal bone loss Misch CE et al. A positive Correlation between occlusal trauma and peri-implant bone loss: Literature review. Imp Dent 2005;14:108-16

7. In the presence of peri-implant mucosal health, a period of 8 months of excessive occlusal load on titanium implants did not result in loss of osseointegration or marginal bone loss when compared with non-loaded implants. Heitz-Mayfield L. et al. Does excessive occlusal load affect osseointegration? An experimental study in dog. Clin Oral Imp Res 2004,15:259-68

8.  The primary concern has now shifted to the durability and lifespan of the prosthesis. Maintenance issues with implant-supported prosthesis are strongly related to occlusal loading Goodacre C. et al. Clinical complications with implants and Implant prostheses. J Prosth Dent 2003 ;90(2): 121-32