Biomechanical and occlusal principles for the success of implant-assisted prostheses

Abstract

Implant-supported prosthetic rehabilitations are subjected to functional loads, such as mastication, as well as parafunctional forces. Therefore, it is important for stomatologists to remain updated on the occlusal characteristics pertinent to this type of rehabilitation. The aim of the present study is to describe the most relevant biomechanical and occlusal principles to ensure the long-term success of implant-assisted prostheses. A narrative review was conducted between January and April 2026, using PubMed, SCIELO, Redalyc, and Google Scholar, with keywords in both English and Spanish. A total of 23 documents were selected, of which 86.9% were published within the last 5 years, 8.7% between 2015–2020, and 4.4% prior to 2015. Biomechanics analyzes internal and external forces interacting with the human body, highlighting differences between natural teeth and implants. The Implant Protective Occlusion was designed to reduce stress at the bone–implant interface through fourteen fundamental considerations, including the elimination of premature contacts, positioning of occlusal contacts over implant bodies, reduction of cantilever lengths, and decreasing crown heights. It was concluded that the most relevant biomechanical and occlusal principles for ensuring the success of implant-assisted prostheses include the implementation of protective schemes, force control through occlusal design that avoids premature contacts and considers cantilever dimensions, optimization of prosthetic parameters, occlusal sequence, and management of parafunctional habits; all of which significantly reduce the risks of mechanical and biological complications and enhance the longevity of implant-assisted rehabilitations