The human tongue is a muscular organ with a variety of life-important functions. Mastication and swallowing, taste, and speech are vital functions. From the analysis of the lingual function, clinical considerations during the oral-pharyngeal phase of swallowing, the tongue thrusts anteriorly and laterally, creating enormous pressure. If it applies to freshly inserted dental implants, it could be leading to early implant failure.
Different authors have calculated this pressure between 20 and 200 kPa, depending on tongue volume, producing resultant torsion forces on implant abutment. The work aims to understand the importance of the destabilizing action of the tongue in the post-operative period.
When the use of implants resting in quiescence for a long time under the gums is not possible, because of anatomical reasons (for example: thin ridge), or: immediate loading is planned, the action of the tongue must be considered.
We are proposing some solutions to the problem to improve therapeutic safety: 1)Attach immediate provisional prostheses to existing adjacent teeth. 2)Immediately upon implants insertion, rigidly connect implants. 3)When an immediate loading protocol is implemented, the operator should follow the guideline, taking care to apply correctly balanced axial forces, without any lateral stress.
Our professional experience, based on over 10.000 clinical cases performed during 35 years, confirms that, with implants emerging in the oral cavity, handling in proper way the tongue thrust during the healing period makes the difference.
All what has been here implemented about this subject, represents the development of the legacy left by Prof. Ugo Pasqualini, an Italian dentist who, since the seventies, has been deepening the topic of the risks tied to the intra-oral stresses acting on the emerging part of the implants.
Dal Carlo L. Study Over 7000 Endosseous Implants Inserted During 25 Years in 3300 Interventions. Clinical Results in Different Anatomical And Functional Situations. Statistical Data and Over 20 Years Iconographic Documentation. Journal of Dental and Oral Health. 2016: 1-10.
Frost HM. Vital biomechanics: Proposed general concepts for skeletal adaptations to mechanical usage. Calcif Tissue Int. 1988; 42: 145–156.
Bianchi A, Sanfilippo F, Zaffe D. Implantologia e implantoprotesi. Utet Torino Italy. 1999. (Italian).
Pasqualini U. Occlusal Pathologies (“Le patologie occlusali”). Masson, Milano. 1993. (French).
Sicher H, DuBrul EL. Oral Anatomy. Ishiyaku EuroAmerica. 1988.
Dal Carlo L. Tongue influence on the integration of endosseous implants. Doctor OS. 2003; 14(5): 479-484.
Casale J, Giwa AO. Embryology, Branchial Arches. [Internet]. 2021. [Updated 2021 August 11] Treasure Island (FL): StatPearls Publishing.
Higashimori M, Shibata A, Ikegami A, Nakauma M, Hori K, Ono T. Half-wave Lissajous curve analysis of tongue pressure while eating gel-like food. J Biorheol. 2018; 32(2): 39–45.
Hayashi H, Hori K, Taniguchi H, Nakamura Y, Tsujimura T, Ono T, Inoue M. Biomechanics of human tongue movement during bolus compression and swallowing. Journal of Oral Science. 2013; 55(3): 191-198.
Hori K, Srinivasan M, Barbezat C, Tamine K, Ono T, Müller F. Effect of lingual plates on generating intra-oral pressure during swallowing: an experimental study in healthy subjects. Journal of NeuroEngineering and Rehabilitation. 2013; 10: 64.
Kydd WL. Quantitative analysis of forces of the tongue. J Dent Res. 1956; 35: 171–174.
Kieser J, Singh B, Swain M, Ichim I, Waddell JN, Kennedy D, et al. Measuring Intraoral Pressure: Adaptation of a Dental Appliance Allows Measurement During Function. Dysphagia December 2007.
Zi-Jun L, Shcherbatyy V, Perkins JA. Functional Loads of the Tongue and Consequences of the Volume Reduction. J Oral Maxillofac Surg. 2008; 66(7): 1351–1361.
Thüer U, Sieber R, Ingervall B. Cheek and tongue pressures in the molar areas and the atmospheric pressure in the palatal vault in young adults. Eur J Orthod. 1999; 21(3): 299-309.
Garbaccio D. The Garbaccio bicortical self-threading screw. Odontostomatol Implantopr. 1983; (1): 53-6.
Spiekermann H, Donath K, Jovanovic S, Richter J: Atlanti di Odontostomatologia. Implantologia. Masson, 1996.
Dal Carlo L, Dal Carlo Z. Elementi di Selezione degli impianti endoossei. Edizioni Accademiche Italiane Marzo 2020.
Pasqualini U, Pasqualini M. Treatise of Implant Dentistry: The Italian tribute to the modern implantology. Carimate (CO) Italy: Ariesdue; 2009.
Meynardi F, Lauritano D, Pasqualini ME, Rossi F, Grivet-Brancot L, Comola G, et al. The importance of occlusal trauma in the primary etiology of periodontal disease. J Biol Regul Homeost Agents. 2018; 32(S1): 27-34.
Pasqualini ME, Rossi F, Meynardi F, Dal Carlo L. Una evidencia clinica del rol del trauma occlusal en la etiologia de la periimplatis. Maxillaris. 2018; 1: 2-14. (Spanish).
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