Chulalongkorn University Dental Journal

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Natural teeth and root form implants are compared from anatomical, physiological and materialmechanical aspects. PDL provides the natural dentition the stress distribution mechanism that is lacking in implants. Functions of the PDL include hydrodynamic vascular system, suspensory mechanism of the collagen fiber, and proprioceptive response. Physiologic mobility in the natural tooth is an adaptive response, while in implant excessive mobility is considered pathological. Material properties and designs of implants are largely different from natural teeth and their surrounding tissue. These factors are contributing to the crestal stress concentration found in implant. Two methods to overcome the problem associated with the lack of the shock-absorbing property in implants are reviewed. Stress-absorbing elements were proposed to stimulate movement provided by the PDL for both restorations supported by implant and implant-tooth. Disadvantages of this method are changing in elastic properties, wear, and frequent replacement of these devices. Another method is to use low modulus of elasticity occlusal materials; eg. acrylic resin, composite resin. These materials may facilitate stress distribution and reduce impact force. However, post insertion wear and fracture frequently occur. Other materials; eg. metal and porcelain are less frequent periodic recall needed and provide more occlusal stable than those soft materials.



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