Implant Crown Occlusal Design — ORE Part 1 MCQ
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Correct answer: E — The occlusal table should be narrower than the natural tooth to reduce lateral forces on the implant
The correct answer is E. Implant-supported crowns require a narrower occlusal table than natural teeth to reduce lateral (shear) forces transmitted to the implant. Unlike natural teeth, which have a periodontal ligament providing proprioception and shock absorption, osseointegrated implants are ankylosed and transmit loads directly to bone. Finite element analyses demonstrate that occlusal loading is the dominant stress factor and that traumatic occlusion significantly increases stress concentrations. Clinical design principles advocate for light, stable occlusal contact with gentler cuspal inclines to minimize lateral forces. Option B is wrong because wider tables increase lateral forces and reduce load distribution. Option A is incorrect; steeper inclines increase lateral shear forces and stress. Option D contradicts evidence showing heavy contact increases stress; gentle contact is preferred. Option C is clinically implausible as functional loading through proper occlusal contact is necessary.
Reference: 1. Gonzalez-Lluch C, Rodriguez-Cervantes PJ, Pérez-González A, et al. 'Influence of crown-to-implant ratio, retention system, restorative material, and occlusal loading on stress concentrations in single short implants.' Implant Dentistry. 2012. PubMed PMID: 22616067. 2. Cehreli MC, Sahin S, Akça K. 'Effects of occlusal inclination and loading on mandibular bone remodeling: a finite element study.' J Prosthet Dent. 2011. PubMed PMID: 21691599. https://pubmed.ncbi.nlm.nih.gov/22616067/