Consideration of biomechanical stress in treatment with dental implants

The most common implant complications, whether associated with the implant or prosthetic restoration, occur as a result of biomechanical stress. These complications include early implant failure, fracture of the prosthesis, abutment or prosthetic screw loosening, implant crestal bone loss, and problems with overdenture attachments. An engineering approach to resolve biomechanical problems involves determining the nature of complications and then designing an approach to eliminate their underlying causes. Treatment planning should incorporate methods to reduce stress and minimize its initial and long-term effects. The treatment plan is altered when forces are greater or bone is less dense than usual to minimize the negative impact of stress on the implant, bone, and restoration. Several parameters under the clinician's control can improve the transosteal environment relative to managing stress on the implant-restoration complex. The goal is to decrease the amount of force, or increase the implant-bone surface area, to decrease the chance of implant-restoration complications.+