Komiyama Osamu, Lobbezoo Frank, De Laat Antoon, Iida Takashi, Kitagawa Tsuyoshi, Murakami Hiroshi, Kato Takao, Kawara Misao
Department of Oral Function and Rehabilitation, Nihon University School of Dentistry at Matsudo, 2-870-1 Sakaecho-nishi, Matsudo 271-8587, Japan.
Int J Biomater. 2012;2012:369063. doi: 10.1155/2012/369063. Epub 2012 Jun 4.
There is general agreement that excessive stress to the bone-implant interface may result in implant overload and failure. Early failure of the implant due to excessive loading occurs shortly after uncovering the implant. Excess load on a final restoration after successful implant integration can result in physical failure of the implant structure. Many clinicians believe that overload of dental implants is a risk factor for vertical peri-implant bone loss and/or may be detrimental for the suprastructure in implant prostheses. It has been documented that occlusal parafunction, such as, bruxism (tooth grinding and clenching) affects the outcome of implant prostheses, but there is no evidence for a causal relation between the failures and overload of dental implants. In spite of this lack of evidence, often metal restorations are preferred instead of porcelain for patients in whom bruxism is presumed on the basis of tooth wear. The purpose of this paper is to discuss the importance of the occlusal scheme used in implant restorations for implant longevity and to suggest a clinical approach and occlusal materials for implant prostheses in order to prevent complications related to bruxism.
人们普遍认为，对骨-种植体界面施加过大压力可能会导致种植体过载和失败。由于负荷过大导致的种植体早期失败发生在种植体暴露后不久。种植体成功整合后，最终修复体上的过大负荷可能会导致种植体结构的物理性失败。许多临床医生认为，牙种植体过载是种植体周围垂直骨丢失的一个风险因素，和/或可能对种植修复体的上部结构有害。有文献记载，咬合异常功能，如磨牙症（磨牙和紧咬牙）会影响种植修复体的效果，但没有证据表明牙种植体的失败与过载之间存在因果关系。尽管缺乏证据，但对于根据牙齿磨损推测患有磨牙症的患者，通常更倾向于使用金属修复体而非瓷修复体。本文的目的是讨论种植修复中使用的咬合方案对种植体寿命的重要性，并提出一种临床方法和种植修复体的咬合材料，以预防与磨牙症相关的并发症。
