Periodontal and Implant Treatment With Computerized Occlusal Analysis

Abstract

The role of occlusion in the progression of periodontal disease remains a controversial subject. Occlusal force, which is a mechanical stress applied to tissues, has always been considered to not initiate, nor accelerate, periodontal attachment loss resultant from inflammatory periodontal disease. This chapter outlines this controversy in great detail, from the perspective that the absence of a validated occlusal force and timing measuring device that can quantify the occlusion, has contributed to the confusion and questions that exist in the scientific community about the relationship between both periodontal disease and peri-implantitis, and the occlusion. The development of a new occlusal measurement technology that records and analyzes precise and reproducible relative occlusal contact force levels in real-time, independent of a clinician's subjectivity, is helping to change the scientific opinion regarding occlusion's role in periodontal and peri-implant supporting tissue loss. The T-Scan 10 system is particularly adapted for treating patients who demonstrate tissue loss combined with occlusal issues. Indeed, after having controlled the major etiologic and risk factors of periodontal disease and peri-implantitis, adjusting the occlusion after active tissue and implant therapy favors healing. The outcome of periodontal treatment aimed at compromised teeth and dental implants, combined with occlusal force excess control from computer-guided targeted occlusal adjustments, is highly predictable, and is characterized by less inflammation, a decrease of probing depths, and the stabilization of bone levels around teeth and dental implants.