Nassim Bachar, Forna Norina, Timpu-Dascalu Aida-Gabriela, Agop-Forna Doriana
DOI : 10.62610/RJOR.2026.2.18.2
Abstract
Objectives. The aim of this narrative review was to evaluate the current evidence regarding the biomechanical principles governing implant-supported fixed and removable restorations and their influence on treatment outcomes, peri-implant tissue preservation, and prosthetic longevity. Materials and Methods. A structured literature search was conducted in PubMed/MEDLINE, PubMed Central, Scopus, and Web of Science. Systematic reviews, meta-analyses, randomized controlled trials, clinical studies, and finite element analyses published between 2000 and 2025 were included. The review focused on biomechanical factors affecting implant-supported fixed prostheses and removable overdentures, including load distribution, implant number and position, implant angulation, cantilever design, prosthetic materials, attachment systems, stress transmission, marginal bone loss, and prosthetic complications. Due to methodological heterogeneity, data were synthesized narratively. Results. Biomechanical performance of implant-supported restorations is strongly influenced by prosthetic design, implant configuration, and occlusal loading conditions. Fixed restorations generally provide favorable load distribution and reduced prosthetic movement, whereas removable implant-supported overdentures offer functional and economic advantages but may generate increased stresses around attachment systems and supporting implants. Factors such as excessive cantilever length, non-axial loading, inadequate implant distribution, and unfavorable crown-to-implant ratios are associated with increased peri-implant stress concentrations, marginal bone loss, and mechanical complications. Advances in digital planning, CAD/CAM technologies, and finite element modeling have improved the understanding and optimization of biomechanical behavior in implant prosthodontics. Conclusions. Biomechanical considerations play a critical role in the long-term success of implant-supported fixed and removable restorations. Individualized treatment planning based on biomechanical principles is essential for minimizing biological and mechanical complications, preserving peri-implant tissues, and enhancing the predictability and longevity of implant prosthetic rehabilitation.
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