Occlusal considerations for single tooth implant crowns

Dental implants have been used to replace missing teeth for over 30 years since research conducted by Brånemark allowed understanding of the concept of osseo-integration¹, which described the relationship of the living bone to a functional implant. According to the Association of Dental Implantology an estimated 130,000 implants were placed in 2012 in the UK.² With many more adults retaining the majority of their teeth into their later years,³ it is likely that more people will opt to have single-tooth gaps restored, with implants being a desirable option compared with traditional fixed bridges. With the rise in popularity of implant therapy, there has been increasing research into the diagnosis and management of complications associated with implant borne restorations. The ITI (International Team for Implantology) has a multitude of consensus statements regarding a variety of reasons for such complications,⁴ occlusion being one of them. Within the ITI Treatment guide Volume 8, occlusal overloading has been attributed to various biological and hardware complications, such as porcelain chipping, screw loosening, potential adverse effects on crestal bone levels, and even possible loss of osseo-integration.⁴