Ten Years in the Making: Sally Rayment's Research on Protecting Implants from the Inside Out
Published by The Implant Centre, featuring Sally Rayment, Restorative Dentist | Haywards Heath
Published by The Implant Centre, featuring Sally Rayment, Restorative Dentist | Haywards Heath
When the Association of Dental Implantology chose its speakers for the inaugural ADI Implant Theatre at the British Dental Conference and Dentistry Show in Birmingham this year, our restorative dentist Sally Rayment, based at our Haywards Heath clinic, was among them. She presented a ten-year clinical audit of implant abutment fractures drawn from her own practice, co-authored with colleagues Michael Packer and Brian Millar, and subsequently published in the British Dental Journal. The ADI then featured her work in their June 2026 member newsletter, which reaches dental professionals across the UK and internationally.
That sequence matters. Invitation to the ADI Implant Theatre, peer-reviewed publication in the BDJ, editorial recognition in the ADI newsletter: these are not the same as a conference badge or a listing on a directory. They reflect a body of evidence, built over a decade, that the profession has taken seriously.
The subject of that evidence is one that affects implant patients directly.
What Is the ADI and Why Does It Matter?
The Association of Dental Implantology is the UK's principal professional organisation for dental implant dentistry. Its editorial content, including the member newsletter, is not paid for or sponsored by clinicians. Being featured is an editorial decision, which is why it carries weight with the profession. The ADI Implant Theatre in 2026 was a new initiative, bringing together leading UK voices in implant dentistry for two days of evidence-based education. It is the context that makes the invitation, and the subsequent write-up, meaningful.
What Sally Presented: A Decade of Evidence on a Growing Problem
Sally's presentation centred on a clinical audit she led over ten years, examining fractures of the abutment component in Ankylos dental implants. The abutment is the connector between the implant post in the jaw and the crown on top. When it fractures under repeated load, the restoration fails and the patient needs intervention.
The audit found a consistent patient profile. Male patients accounted for 62% of cases. The first molar was the site involved in 84% of cases. These are not random distributions. They point to a specific and identifiable risk, and the underlying driver in the great majority of cases is parafunction: the habitual clenching and grinding of teeth.
Sally noted that the problem has been compounded by delayed treatment during the pandemic. In her words: "A lot of dental problems were left to become worse during the pandemic. This is not a problem that is going to go away."
What Is Parafunction and Why Should Implant Patients Know About It?
Parafunction is the clinical term for involuntary habitual loading of the teeth outside of normal function. In practical terms: clenching or grinding that puts abnormal, repetitive force through the teeth and jaws, far beyond what eating and talking would normally produce. Teeth are designed to be in contact for only a few minutes a day during normal chewing. In people who clench or grind habitually, that contact can run for hours.
In natural teeth, this causes visible wear, cracking and the gradual breakdown of restorations. In implant patients, it puts those same forces through components engineered for normal biting loads. The result, as Sally's audit documents, can be abutment fractures and restoration failure.
What makes parafunction particularly difficult to manage is that it is not a fixed condition. A patient who shows no signs of grinding at the time of implant placement may develop it months or years later, triggered by stress, disrupted sleep or changes in medication. Because it often happens during sleep, many patients are entirely unaware of it until the damage is already showing. As Sally put it: "We need to get better at asking patients how they're doing."
This is a key point for anyone with dental implants: parafunction risk is not assessed once and closed. It is worth revisiting at every review appointment. It is a standard part of how we approach implant monitoring at The Implant Centre.
The Treatment That Changes the Equation
The conventional approach to protecting teeth and implants from grinding has long been the occlusal splint, typically the Michigan splint, worn over the teeth at night to cushion the bite. In the right patient, used consistently, it works. The difficulty is that word: consistently. Splints depend entirely on the patient putting them in. Those who need the most protection are often the least able to maintain the habit.
The treatment Sally described as transformative takes a different approach. Botulinum toxin injected into the masseter muscle, and where required the temporalis, reduces the force that muscle can generate by approximately 40% at eight to twelve weeks post-injection, based on the clinical evidence reviewed in Sally's presentation. The effect does not depend on what the patient does after the appointment. The injection is given and the reduction in bite force follows. Whether this is appropriate for you is something to establish at a clinical assessment.
This is not a cosmetic procedure in this context. It is a clinical intervention for parafunction management and implant protection, and it is one that Sally offers at The Implant Centre in Haywards Heath as part of her clinical practice. Results typically last between three to six months, with variation depending on individual muscle mass, the strength of the clenching habit, and how quickly the body processes the product. Regular maintenance treatments are usually recommended to sustain the protective effect. She described the treatment plainly: "An absolute game changer."
One of her patients described the result as both painless and profoundly relieving, a response Sally says is typical rather than exceptional.
She added: "For myself, this is the most rewarding part of dentistry."
Two barriers are worth acknowledging honestly. Many patients have not heard of masseteric botulinum toxin treatment, or associate it primarily with cosmetics rather than dental protection. Older male patients, who make up the highest-risk group in Sally's audit findings, are also the group most likely to hesitate when the word Botox comes up. The conversation, Sally acknowledges, requires care. But it is one worth having.
If this is something you would like to understand more about, our jaw pain and teeth grinding treatment page covers the clinical approach in detail, and our facial aesthetics page explains the full range of treatments Sally offers at the clinic.
What This Means If You Are a Patient at The Implant Centre
Sally has been part of The Implant Centre team since 2010, based at our Haywards Heath clinic. She qualified at Guy's, King's and St Thomas' Hospital in 2004, placed her first implant restorative case in 2005 and holds a Master's degree in prosthodontic dentistry from King's College London. The audit that led to this recognition was not a research project she undertook to build a profile. It came from sustained, careful attention to her own clinical outcomes over ten years, and a question that implant clinicians rarely ask in enough depth: why did this fail, and what can we do about it?
That kind of attention to outcome is what makes the findings useful, not just to the profession, but to patients. The research points toward practical action: more thorough parafunction screening, more open conversations about stress and sleep, and a clinical tool that reliably reduces bite force without depending on patient compliance.
You can read more about Sally's background and clinical work on her clinician profile page, and explore our full range of dental implant treatments.
Worth a Conversation
If you clench or grind your teeth, whether you already have implants or are considering them, it is worth raising at your next appointment. The same applies if you wake with jaw tension or unexplained headaches, or have been told in the past that you grind in your sleep. These are the questions that catch a developing problem early, before it reaches the restorations.
For existing patients, your review appointment is the right moment. For anyone new to the clinic, it is exactly the kind of thing we assess from the outset.
To book a consultation with our team, visit our online booking page.
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