Evaluation of the Alteration of Occlusal Distribution in Unilateral Free-End and Intermediate Missing Cases
The present study aimed to evaluate the effect of implant prostheses on the occlusal force and area as well as the distribution of occlusal loading in unilateral free-end and intermediate missing cases. Fourteen healthy subjects (7 free-end missing cases in the first and second molars and 7 intermediate missing cases in the first molar region) were included. Six months after the implant prosthesis was placed, an occlusal evaluation was performed with or without the implant superstructure by using Dental Prescale film and an occluder device. In free-end missing cases, the total occlusal force and area, implant-side occlusal force and area, and implant-side occlusal force and area of the residual natural teeth were significantly affected by the implant prostheses. In intermediate missing cases, the implant-side occlusal force of the residual natural teeth was significantly affected by the implant prostheses. In free-end missing cases, the proportions of implant-side occlusal force, non–implant-side occlusal force, and implant-side occlusal force of the residual natural teeth relative to the total occlusal force were significantly affected by the implant prostheses. In the intermediate missing cases, the proportion of the implant-side occlusal force of the residual natural teeth relative to the total occlusal force was significantly affected by the implant prostheses. The proportion of the occlusal area was also significantly affected. In free-end missing cases, implant prostheses significantly increased the occlusal force and area, which resulted in the proper occlusal distribution. In intermediate missing cases, an implant prosthesis may only improve the same-side occlusal loading of the natural teeth.

Figure 1. Panoramic radiograph of a free-end missing case. Dental implant treatment was applied at 2 and 3. Figure 2. Panoramic radiograph of an intermediate missing case. Dental implant treatment was applied at 19.

Figure 3. Occlusal force determined for each region by using Dental Prescale film. The bar chart shows the mean occlusal force. Error bars indicate the standard deviation. Figure 4. Occlusal area determined for each region by using Dental Prescale film. The bar chart shows the mean total occlusal area. Error bars indicate the standard deviation. Figure 5. Ratio between the occlusal force and implant or non–implant-side occlusal force. The bar chart shows the mean ratio between the occlusal force and the implant or non–implant-side occlusal force. Error bars indicate the standard deviation. Figure 6. Ratio between the occlusal area and implant or non–implant-side occlusal area. The bar chart shows the mean ratio between the occlusal area and implant or non–implant-side occlusal area. Error bars indicate the standard deviation.
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