Identifying occlusal overload and how to deal with it to avoid marginal bone loss around implants

Background: Occlusal overloading is the primary cause of biomechanical implant complications, which include fracture and/or loosening of the implant fixture and/or prosthetic components. It may also disrupt the intricate bond between the implant surface and bone, leading to pen-implant bone loss and eventual implant failure. Purpose: This paper was aimed at identifying and evaluating clinical and radiographic parameters relevant for diagnosing occlusal overloading of oral implants. It also discusses its management in order to prevent pen-implant marginal bone loss. Materials and methods: An electronic literature search for relevant studies, examining the relationship between occlusal overloading and pen-implant bone loss, was conducted in the PubMed database. Clinical human studies published in English with a minimum of 10 implants were included. Results: Seven articles were identified. Occlusal overloading was found to be positively associated with pen-implant marginal bone loss. Conclusion: Preventing occlusal overloading involves conducting comprehensive examinations, treatment planning, precise surgical and prosthetic treatment executions, and regular maintenance. If occlusal overloading occurs, management of biomechanical implant complications and preventing/treating pen-implant bone loss involves surgical and prosthetic treatment modalities. They include occlusal treatment, repair and replacement of defective prosthetic components, and surgical treatment of the bony craters.