In the nineties, there was a general belief that mechanical overloading was one of the main reasons for implant failure. Clinical and animal experimental studies on early and immediate implant loading provide information on the impact of mechanical loading on the establishment of osseointegration. Animal experimental studies also indicated the potential detrimental effect of excessive load on the sustainability of osseointegration, although controlled clinical trials are lacking. Research is challenged by the fact that clinical situations represents a blend of many influencing factors such as microbial and mechanical loading, surgical technique, prosthetics, patient-related factors such as bone quality and quantity, immune response, microcirculation, etc. This makes it difficult to evaluate the impact of a sole factor.
The available evidence and its clinical relevance will be discussed
Joke Duyck is professor at the department of Oral Health Sciences (Division of Prosthodontics) of the Catholic University of Leuven, Belgium. She graduated as a dentist in 1995 and as a prosthodontist in 2000. She combined her clinical training with a PhD in Medical Sciences on ‘Biomechanical characterisation of oral implants’ in collaboration with the University of Oslo, which she defended in January 2000. Since then, Dr. Duyck continued to combine basic research on implant biomechanics and peri-implant bone biology with clinical practice in prosthodontics and gerodontology. She authored over 75 papers and is active in several scientific committees and international journals.