Title Occlusal Overload May Contribute to Late Implant Failure in Patients with Anterior Dental Implants
Clinical Question In patients with anterior dental implants, does occlusal overload contribute to late implant failure?
Clinical Bottom Line Occlusal overload may contribute to late implant failure in patients with anterior dental implants. There is a large amount of variability across the literature quantifying implant overload and its effect on late implant failure, with much of the literature coming from animal studies. The increased prevalence of late implant failures in the posterior areas of the mouth is well documented in humans, as well as the increased rate of late failures in patients suffering from peri-implantitis. More research is still needed to properly identify if occlusal overload is a sole contributor to late implant failure.
Best Evidence  
PubMed ID Author / Year Patient Group Study type
(level of evidence)
19925986Manor/2009194 patients who experienced at least one failed and removed dental implant during a 6-year period.Retrospective Cohort Study
Key resultsOf the 194 patients analyzed in this study, 97 presented with early implant failure and 97 with late implant failure over a 6-year period (from 2000-2006). Implant overload and peri-implantitis were the two most common reasons for late implant failure, causing 32% and 46.4% of all late failures, respectively. Implants placed in the posterior areas of the maxilla or mandible were also found to have a significantly higher incidence of failure (64 of the 97 presenting cases, P=.029).
23062133Naert//20123 animal research studies selected from a pool of 41 clinical and animal research studies.Systematic Review
Key resultsKozlovsky observed histological increases in bone resorption in dog models with supra-occluded implants with peri-implantitis. Bone to implant contact was also significantly increased in the case of implant overloading. In animal models, occlusal overload in the presence of plaque induced inflammation markedly increased bone resorption.
Evidence Search (dental occlusal overload) OR (late dental implant failure)
Comments on
The Evidence
In the Manor et. al., article, it is not known if the patients were treated the same at the time of implant placement. It is also unknown if there were other characteristics that were not measured that could have also contributed to early or late implant failure. No competing interests were stated. In the Naert et. al., article, all 3 of the articles included in the systematic review were performed on animal models with small sample sizes. 41 potentially relevant clinical and animal research articles were screened; with only 3 of the articles remaining after exclusion criteria were applied. Across the literature, there is a very limited amount of information regarding impact overload, with a high degree of variability between the articles available. Detailed interpretation must be performed on the part of the reader to interpret and identify any clinically relevant information regarding impact overload and its effect on late implant failure.
Applicability The patients involved in this study would be representative of patients presenting with late implant failure. Since the anterior maxilla and mandible is such an esthetically and functionally important location for dental implants, identifying the potential harm that can arise from prolonged impact overload is essential for long-lasting dental implants.
Specialty (General Dentistry) (Oral Surgery) (Periodontics) (Prosthodontics)
Keywords Anterior dental implants, late implant failure, implant overload
ID# 2647
Date of submission 02/26/2014
E-mail lukeh@livemail.uthscsa.edu
Author Harrison Luke
Co-author(s) e-mail
Faculty mentor Barbara MacNeill, DMD
Faculty mentor e-mail macneill@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
None available
Comments and Evidence-Based Updates on the CAT
None available