Thursday, November 23rd 2017 2:08AM EST

Occlusal Considerations

Occlusal Considerations

  • Attempt to use 4.5mm or wider implants especially for canine and posterior implants.
  • Ridge splitting techniques can facilitate the use of wider implants.
  • Splint maxillary single implants to eliminate the possibility of their loosening when adverse occlusal patterns and/or poor implant positioning exist.
  • Place one implant per missing tooth, if possible, especially posterior to the canine.
  • Occlusal forces should be directed as close as possible to the long axis of the implant.
  • Check maxillary incisal contacts while the patient is maximally clenching in all extreme excursions.
  • Establish bilateral and simultaneous occlusal contacts.
  • Establish precise cuspal or incisal disclusion, especially for unsplinted maxillary anterior restorations.
  • Avoid lateral occlusal contacts.
  • Occlusion should be checked initially before and after the final insertion of the restoration with 40 micron thick articulating paper and again during post-insertion visits.
  • Establish points of cuspal contact versus broad flat occlusal contacts.
  • Restore an implant in a cross bite relationship, if necessary, to avoid a cantilever restoration.
  • Avoid mesial and especially distal cantilevers posterior to the canine.
  • Avoid buccal and lingual cantilevers, as well as mesial and distal cantilevers.
  • Gothic arch tracing and face bow techniques are recommended as an aid in establishing and recording proper tooth and jaw relationships prior to the placement of implants. They may be used again after abutment placement to confirm jaw relationships.