Therapeutic biomechanics concepts and clinical procedures to reduce implant loading. Part I.

A new approach called therapeutic biomechanics that uses 5 possible corrective procedures that can be used in conjunction with each other to reduce implant loading has been suggested. These procedures are the following: (1) a cross-occlusion (to reduce horizontal implant offset); (2) the head (hex) of the implant should be placed as close to the midline of the restoration as possible; (3) angled or custom reangulated abutment; (4) shallow cusp inclines; and (5) modified centric occlusal anatomy. On maxillary anterior restorations, a horizontal lingual stop redirects the resultant line of force in a vertical direction much closer to the implant and supporting bone. Part II of this paper will focus on laboratory and clinical procedures to implement the concept of therapeutic biomechanics.