Higher Implant Success Rate with Non-Functional Loading
The concept of non-functional immediate teeth was proposed by Carl Misch (Fig 10-1). It indicates
that, during loading of prosthesis, the prosthesis should be adjusted so that there is no direct
contact between the prosthesis and the opposing tooth. Methods of achieving non-functional
loading are the following:
1. Utilize acrylic material to fabricate a temporary prosthesis. The prosthesis wears out in 2
weeks and, therefore, non-functional loading can be achieved.
2. When a permanent prosthesis is to be loaded, surgeon needs to adjust the prosthesis so that
an occlusal clearance of 100~150μm is achieved.
Prosthesis mobility and dental implant failure usually happen at the second molar area in one
month after implant placement. The methods above can minimize their occurrence.
Another concept introduced by Carl Misch is “Progressive Bone Loading”. During progressive bone
loading, the bone is given time to respond to gradual increase in occlusal load. This improves the
quantity of bone at the implant interface, increases bone density, and enhances the overall support
When loading a single prosthesis, surgeon needs to create an occlusal clearance of 100~150μm
between the prosthesis and the opposing tooth.
NONFUNCTIONAL IMMEDIATE TEETH
• Partially edentulous patients with centric occlusal contacts and excursions on natural teeth ( or
• Division D1, D2 and D3 bone in regions of implants
• Screw-shaped implant bodies, 4mm or more in diameter, with increased surface area designs to
decrease crestal stresses (e.g., BioHorizons Maestro dental implant).
Patients with parafunctional oral habits (i.e., anterior and lateral tongue thrust or biting on a pipe