Occlusion for Implant Prosthodontics

The purpose of implant-supported restorations is to restore form, function and aesthetics. It is widely recognized that one of the most contentious areas of implant prosthodontics is occlusion. Historically, occlusion in implant prosthodontics evolved from a combination of expert opinion, in vitro research, animal studies and extrapolation from concepts applied to natural teeth. In many cases, clinicians appear to be applying paradigms learned from occlusion in the natural dentition to implant-supported restorations. The evidence to support such applications is lacking, and often the clinician is faced with more questions than answers. The bio-physiologic differences between a tooth and an implant make application of the occlusion literature for natural teeth to endosseous dental implants nearly impossible. It is interesting to note that at present, there does not appear to be much scientific support for one idea over another in the realm of occlusion. Following a thorough analysis of the literature on occlusion, Taylor et al. (J Prosthet Dent 94(6):555–60, 2005) concluded that there is insufficient scientific data to establish a causal association between occlusal variables and adverse biological consequences for osseointegrated implants. The purpose of this chapter is to discuss various occlusal considerations for implant-supported restorations and to provide the clinician with guidelines on the choice of occlusal scheme in clinical practice.