Bruxism and Dental Implant Therapy Complications: a Systematic Review

Objectives: Bruxism is a common parafunction which was usually considered as a contraindication for oral implanting. The causal relationship between bruxism and dental implant failure is a subject of long-term controversy. This systematic review of literature was performed to investigate if bruxism could be considered as a risk factor for dental implant-supported rehabilitations failures or complications.
Methods: An electronic search was conducted in MEDLINE database using PubMed with the following controlled vocabulary combination:
("Bruxism"[Mesh]) AND ("Dental Implants"[Mesh] OR "Dental Prosthesis, Implant-Supported"[Mesh]). Meanwhile, a hand searching for all the relevant references of included studies was also conducted. The selected articles were reviewed according to a structured summary of the articles in relation to four main issues: “P” – patients/problem/population, “I” – intervention, “C” – comparison, and “O” – outcome.
Results: According to pre-established inclusion and exclusion criteria, a total of 24 studies involving a total of 8300 subjects and 26337 implants were selected. In seven studies, a significant positive relationship was found between bruxism and dental implant failure. Furthermore, a relationship between bruxism and the occurrence of complications in implant-supported prostheses has been described in nine studies with more mechanical than biological complications. On the other hand, bruxism was not related with implant failures and/or complications in eight papers.
Conclusions: Bruxism could play a role in dental implant failures (loss of osseointegration or fracture) but it is especially a risk factor for the occurrence of mechanical complications of the implant-supported rehabilitations. However, this relationship seemed to be influenced by other confounding risk factors such as smoking, diabetes and bone quality.