Bruxism and Implant-Supported Fixed Prosthesis : Systematic Review of the LittéRature

Objectives: Bruxism is a disorder characterized by involuntary teeth grinding during wakefulness and/ or sleep. This phenomenon represents one of the most critical problems in implant-supported prosthetic rehabilitation. The purpose of this systematic review is to evaluate the impact of bruxism, as a risk factor, on implant-supported fixed prostheses and to establish recommendations to avoid such complications.
Methods: The research was performed through MEDLINE database via the interfaces Pubmed and EBSCOhost using the following boolean formula : ((Bruxism OR parafunctional OR overload) AND (dental implant OR oral implant OR implant supported prosthesis) AND (survival OR success OR risk factor OR complications OR implant failure)). Data from the selected studies were extracted and analyzed.
Results: Fifteen prospective and retrospective cohort studies were included in our review and their data were extracted using a grid established for this purpose. Eight studies were conclusive in favor of a significant influence of bruxism on dental implant failure, four found no significantly increased risk of complications and the three other studies did not provide a clear and definitive conclusion. As for complications, most authors agree that they are of two types: biological and mechanical.
Conclusions: Bruxism is not a contraindication to implant supported fixed prosthesis, but certain precautions concerning the type and the positions of implants and the prosthetic design must be respected. A night protection splint is recommended. A regular control must be established.