Therapeutic Biomechanics Concepts and Clinical Procedures to Reduce Implant Loading. Part II: Therapeutic Differential Loading

Practical laboratory procedures were suggested in order to provide a modified occlusal anatomy to reduce implant loading. The concept of differential mobility caused by the flexion between a natural tooth/periodontal ligament interface with its supporting bone, compared with the stiffness of the implant/bone interface, was described. When individual tooth-supported and implant-supported prostheses coexist in the same arch, this differential mobility can shift the loading disproportionately from the natural teeth to the implants. A new concept of therapeutic differential loading is introduced and a clinical technique of differential occlusal adjustment is described to bring about a more favorable distribution of loading to all the supporting bone. Long- term natural tooth intrusion can cause implant overload. Therefore, it is suggested that periodic differential occlusal adjustment procedures be used to re-establish a long-term balance of loading between individual implant- and tooth-supported prostheses within the same arch.