Dental Implants In Oral Reconstruction

By Celeste Balino, DDS

For over 60 years, dental implants have been utilized to replace defective or missing teeth. The efficacy of the treatment is beyond dispute, however, the increased use of dental implants has made some dental treatments more complicated, particularly bite or occlusion challenges.

Implants and teeth react differently under compressive loads and shear loads (i.e. chewing). The dental implantologist must be aware of the potential for dissimilar reactions of implants when compared to teeth.

Teeth have a “cushion” often referred to as the periodontal membrane that helps distribute or dissipate force placed on the tooth before it travels to the supporting bone. An implant on the other hand, accepts the full brunt of the load and transfers it directly to bone.

These differing scenarios when occurring during the chewing cycle can cause porcelain crowns or fillings to wear prematurely or fracture when the load increases beyond the tolerance of the restoration.

The challenge for the implantologist is to carefully “balance the bite” so that the forces are all transferred equitably. To do this, it is incumbent that the implantologist have the scientific background and instruments to be able to render this important phase of oral rehabilitation.

There is equipment available to take the guesswork out of bite management and thereby saving costly repairs and replacements during dental reconstruction.

The first sign of bite compromise may be a dark mark on the biting surface of your porcelain crown where the chewing forces are out of sync with your normal chewing cycle.

The second sign may be a fracture or craze line in your veneer or crown that you may attribute to the age of the restoration. The great majority of the time this is directly associated with a faulty and uncorrected bite pattern.

The third sign may be discomfort or pain when there is no obvious cavity. On close inspection, your dentist may see wear patterns that are an indication of bite problems.

Please ask your dentist for help if any of these signs are present, particularly when you have implants as a part of your dental restorations.