Abstract:

Implant dentures have become the main method for the treatment of dentition defects or complete edentulism. However, due to the lack of periodontal ligament and periodontal ligament proprioceptors, implant dentures have very limited cushioning and sensing capabilities and are prone to occlusal overload. As a risk factor for peri-implantitis, occlusal overload seriously threatens the stability and success rate of implant dentures. This paper reviews the occlusal overload of implant dentures, the causal relationship between occlusal overload and plaque biofilms in peri-implantitis, the mechanism by which occlusal overload promotes peri-implantitis, and the effect of reasonable clinical occlusal adjustment on healing. This review shows that occlusal overload is closely related to the occurrence of peri-implantitis. Occlusal overload can promote the process of peri-implantitis by increasing the release of inflammatory factors and mechanical transduction mechanisms. The intervention of the patients’ bad bite habits and occlusal adjustment can promote the healing of peri-implantitis. At present, there is no uniform standard ideal experimental model for occlusal overload. The phenomenon and mechanism of bone resorption around the implant caused by overload force still need further observation and research, which will help determine the intensity, direction and timing of occlusal loading to guide clinical occlusal adjustment.

Key words: dentition defect, dentition loss, implant denture, peri-implantitis, occlusion, occlusal forces, occlusal overload, masticatory loading, osseointegration

摘要：

种植义齿已成为治疗牙列缺损或牙列缺失的主要修复方式,而种植义齿由于其自身缺乏牙周膜及牙周膜本体感受器,因此缓冲及感知的能力十分有限,容易发生咬合过载。咬合过载作为种植体周围炎的危险因素,严重影响种植义齿的稳定性和成功率。本文就种植义齿的咬合过载、咬合过载与细菌生物膜在种植体周围炎中的因果关系、咬合过载促进种植体周围炎的机制、临床上合理的咬合调整对炎症愈合的影响作一综述。文献复习结果表明,咬合过载与种植体周围炎的发生密切相关;咬合过载可通过增加炎症因子释放和机械转导机制促进种植体周围炎的进程;通过对患者不良咬合习惯的干预和咬合调整,可促进种植体周围炎组织的愈合。目前,咬合过载并无统一标准的理想实验模型,由过载力导致的种植体周围骨吸收现象及机制仍需进一步观察及研究,有助于明确咬合负荷加载的强度、方向及时间,从而指导临床的咬合调整。

关键词: 牙列缺损, 牙列缺失, 种植义齿, 种植体周围炎, 咬合, 咬合力, 咬合过载, 咀嚼负荷, 骨结合