Why Your Implants Fail: Occlusion Mistakes You Didn’t Know You Were Making

Dental implants have come a long way. Materials are stronger, workflows are faster, and guided surgery is more precise than ever. So why are so many restorations still failing?

In many cases, it’s not the implant. It’s the occlusion.

The Hidden Culprit Behind Implant Failure

You followed the protocol. The CBCT looked good. The crown was beautiful. But the patient still ends up with screw loosening, porcelain chipping, or bone loss around the implant. Sound familiar?

The truth is, most dentists underestimate the role of occlusion in implant longevity. Worse—many are using the same occlusal principles they learned in dental school… on a system that doesn’t behave like natural teeth.

Here's what you may be missing:

1. Implants Don’t Have Proprioception

Unlike natural teeth, implants lack a periodontal ligament. That means they don’t have the same ability to detect and adapt to force. Your patient might not feel anything—but that doesn’t mean the implant isn’t under stress.

If the bite is even slightly off, the forces don't get redistributed. They land full-force on the restoration. Over time, that adds up.

2. You’re Using Tooth-Based Occlusal Schemes

Canines are supposed to guide. Molars are supposed to have broad contact. That’s fine—if there’s a PDL involved. But when you restore an implant like a natural tooth, you're loading it with forces it can’t handle.

In posterior implants, broad occlusal tables and wide contacts are a recipe for overload. In anterior cases, transferring lateral guidance to an implant can fracture a crown—or worse, damage the bone.

3. Lateral Forces Are Killing Your Case

Occlusion isn't just about “even contacts.” It's about force direction. Implants love vertical load. But lateral shear? That’s where things break down.

If your occlusal contacts aren’t axial, you’re inviting micro-movements that can lead to screw loosening, component fatigue, and peri-implantitis. The scary part? You might not notice until the bone is already gone.

4. You’re Not Accounting for Parafunction

Most of your patients are grinding. Some of them don’t even know it. When you restore an implant without managing parafunction—either with orthotic stabilization or controlled occlusal design—you leave it defenceless.

The result? Fractured ceramics. Cracked abutments. Patients returning months later with “something feels off.”

What You Can Do Differently

There’s good news: implant failures caused by occlusion are preventable. But only if you stop treating implants like teeth.

Here’s where to start:

Narrow Your Occlusal Table

Especially in posterior restorations, design crowns with reduced buccolingual width. This limits lateral force vectors and directs load vertically.

Minimize Excursive Contacts

Implants should be out of the picture during excursive movements. Let the natural teeth handle guidance—your implant isn’t designed to do that job.

Use Shimstock and Foil, Not Articulating Paper Alone

Implant occlusion needs precision. That “perfect contact” on paper might be deceiving. Layer your diagnostics—use shimstock for verification, articulating foil for detail, and Tekscan for force distribution.

Pre-treat with Orthotics in High-Risk Cases

If a patient has a history of TMD, bruxism, or instability, stabilize first. Orthotic therapy allows you to assess muscle behavior and joint response before committing to final restorative work.

Adjust at Delivery—and at Follow-Up

Don’t assume the occlusion you delivered is the one they’ll still have in six weeks. Follow up, check load again, and be ready to adjust. Occlusion is dynamic—even if the implant isn’t.

Final Thoughts

The implant may osseointegrate beautifully. The lab work might be stunning. But if your occlusion is off, none of that matters.

Implants don’t fail because they’re weak. They fail because we overload them with forces they were never designed to handle.

Start thinking differently about occlusion. Protect the joint, control the force, and stop treating implants like teeth.

Want to learn how to fix this?

Join me in “Why Your Implants Fail” series, where we break down:

The top occlusion mistakes in implant dentistry

Clinical protocols to protect your restorations

Step-by-step design strategies for long-term implant success

Register now at TMJWhispererAcademy.com
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