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Berzaghi A, Testori T, Scaini R, Bortolini S. Occlusion and Biomechanical Risk Factors in Implant-Supported Full-Arch Fixed Dental Prostheses-Narrative Review. J Pers Med 2025; 15:65. [PMID: 39997342 PMCID: PMC11856061 DOI: 10.3390/jpm15020065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2024] [Revised: 02/01/2025] [Accepted: 02/05/2025] [Indexed: 02/26/2025] Open
Abstract
The biophysiological differences between teeth and dental implants and the issue of occlusal overload, although controversial, form the basis for the management of occlusion in implant-supported full-arch fixed dental prostheses (ISFAFDPs). Although there is currently a lack of scientific evidence on occlusal management, it is clear that the favorable prognosis of ISFAFDPs is linked to a correct understanding of the biomechanical principles involved. In the design of ISFAFDPs, the lack of proprioceptive feedback requires special attention to biomechanical factors: minimizing overloading complications and providing biomechanical stability are among the main goals of the occlusion. In ISFAFDPs, the occlusion must be decided on the basis of several factors that influence the loads on prosthesis and implants: each case must be evaluated individually and requires a personalized occlusion. The main aim of this narrative review is to provide an overview of the occlusal principles and materials that can be used in ISFAFDPs based on the data currently available in the literature. Practical clinical recommendations for the occlusion management of ISFAFDPs and a biomechanical risk score index to personalize implant-prosthetic treatment are proposed.
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Affiliation(s)
- Andrea Berzaghi
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia (UNIMORE), 41125 Modena, Italy;
| | - Tiziano Testori
- IRCCS Galeazzi S. Ambrogio Hospital, Dental Clinic, Section of Implant Dentistry and Oral Rehabilitation, 20157 Milan, Italy; (T.T.); (R.S.)
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI 48109, USA
- Department of Oral Medicine, Infection and Immunity, School of Dental Medicine, Harvard University, Boston, MA 02115, USA
| | - Riccardo Scaini
- IRCCS Galeazzi S. Ambrogio Hospital, Dental Clinic, Section of Implant Dentistry and Oral Rehabilitation, 20157 Milan, Italy; (T.T.); (R.S.)
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
| | - Sergio Bortolini
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia (UNIMORE), 41125 Modena, Italy;
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Onică N, Budală DG, Baciu ER, Onică CA, Gelețu GL, Murariu A, Balan M, Pertea M, Stelea C. Long-Term Clinical Outcomes of 3D-Printed Subperiosteal Titanium Implants: A 6-Year Follow-Up. J Pers Med 2024; 14:541. [PMID: 38793123 PMCID: PMC11122366 DOI: 10.3390/jpm14050541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 05/09/2024] [Accepted: 05/16/2024] [Indexed: 05/26/2024] Open
Abstract
As an alternative to regenerative therapies, numerous authors have recently proposed bringing back subperiosteal implants. The aim of the study was to present our clinical experience with a subperiosteal jaw implant that needs minimal bone preparation and enables the rapid implantation of prosthetic teeth in edentulous, atrophic alveolar bone. The research included 36 complete or partial edentulous patients (61 subperiostal implants) over a period of 6 years. To create the patient-specific subperiostal implants design, DentalCAD 3.0 Galway software (exocad GmbH, Darmstadt, Germany) was used and fabricated with a Mysint 100 (Sisma S.p.A., Piovene Rocchette, Italy) by titanium alloy powder. The results showed that only 9 of the 36 cases were successful at 6-year follow-up, while 27 cases had complications, including exposure of the metal frame (early or delayed), mobility of the device prior to the first 4-6 months, and late mobility due to recurrent infections and progressive structure exposure; 1 case failed for reasons unrelated to the device. This study indicated that the prudent application of fully customized subperiosteal jaw implants is a dependable alternative for the dental rehabilitation of atrophic edentulous cases that necessitate bone grafts for traditional fixed dental implant solutions.
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Affiliation(s)
- Neculai Onică
- Department of Surgery, Faculty of Dental Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (N.O.); (G.L.G.); (A.M.); (M.B.); (C.S.)
| | - Dana Gabriela Budală
- Department of Implantology, Removable Dentures, Dental Technology, Faculty of Dental Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania;
| | - Elena-Raluca Baciu
- Department of Implantology, Removable Dentures, Dental Technology, Faculty of Dental Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania;
| | - Cezara Andreea Onică
- Department of Surgery, Faculty of Dental Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (N.O.); (G.L.G.); (A.M.); (M.B.); (C.S.)
| | - Gabriela Luminița Gelețu
- Department of Surgery, Faculty of Dental Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (N.O.); (G.L.G.); (A.M.); (M.B.); (C.S.)
| | - Alice Murariu
- Department of Surgery, Faculty of Dental Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (N.O.); (G.L.G.); (A.M.); (M.B.); (C.S.)
| | - Mihail Balan
- Department of Surgery, Faculty of Dental Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (N.O.); (G.L.G.); (A.M.); (M.B.); (C.S.)
| | - Mihaela Pertea
- Department of Plastic Surgery, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania;
| | - Carmen Stelea
- Department of Surgery, Faculty of Dental Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (N.O.); (G.L.G.); (A.M.); (M.B.); (C.S.)
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McCoy G. Letter to the Editor. J ORAL IMPLANTOL 2023; 49:457. [PMID: 38349659 DOI: 10.1563/aaid-joi-d-49-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
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