The implant body should be loaded in an axial direction. In a division A
maxillary ridge the implant can be placed between the central fossa
region and buccal cusp of the natural teeth. The buccal cusp of the
natural tooth in the mandibular arch is the dominant occluding cusp. The
palatal contour of the maxillary posterior implant crown is reduced to
eliminate offset loads. The position of the maxillary buccal cusp should
remain similar to that of the original tooth for proper esthetics and
should remain out of occlusion in CR and all mandibular excursions. When
further resorption occurs and the ridge evolves into division B to C
bone, the maxillary palatal cusp may become the primary contact area,
situated directly over the implant body. The palatal cusp angle is
reduced, and a contact area is created directly over the implant
abutment. Hence, the occlusal contacts differ from those of a natural
tooth.