{"title":"Bruxism in implant-supported rehabilitations: a narrative review of clinical complications and management strategies.","authors":"Elnaz Shafiee, Amin Nourizadeh","doi":"10.1186/s12903-025-07005-y","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Bruxism represents a significant risk factor for complications in implant-supported rehabilitations. Unlike natural teeth cushioned by periodontal ligament, the rigid osseointegrated connection transmits excessive bruxing forces directly to the implant-bone interface and prosthetic components.</p><p><strong>Objective: </strong>This narrative review synthesizes current knowledge regarding bruxism-related complications in implant-supported rehabilitations and evaluates available management strategies.</p><p><strong>Methods: </strong>A comprehensive narrative review was conducted using PubMed/MEDLINE, Embase, Web of Science, Scopus, Cochrane Library, and Science Direct databases covering publications from January 1990 to December 2024. Studies investigating bruxism's relationship with dental implant outcomes, clinical complications, and management strategies were included.</p><p><strong>Results: </strong>Systematic reviews demonstrate that bruxing patients have 2.2-4.7 fold increased implant failure risk compared to non-bruxing patients. Finite element analyses reveal that occlusal splints reduce stress concentration by 33-73% depending on load magnitude. Limited evidence exists regarding the association between bruxism and peri-implant bone loss. Technical complications include prosthetic component fractures, screw loosening, and framework failures. Management strategies include occlusal splint therapy, modified prosthetic designs, strategic implant placement, and comprehensive follow-up protocols.</p><p><strong>Conclusions: </strong>While bruxism significantly increases the risk of complications in implant-supported rehabilitations, successful outcomes are achievable through comprehensive management approaches. Evidence supports the effectiveness of occlusal splints in stress reduction and splinted prosthetic designs for optimal force distribution. However, the relationship between bruxism and implant complications remains complex, requiring standardized diagnostic criteria and evidence-based treatment protocols.</p>","PeriodicalId":9072,"journal":{"name":"BMC Oral Health","volume":"25 1","pages":"1586"},"PeriodicalIF":3.1000,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512445/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Oral Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12903-025-07005-y","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Bruxism represents a significant risk factor for complications in implant-supported rehabilitations. Unlike natural teeth cushioned by periodontal ligament, the rigid osseointegrated connection transmits excessive bruxing forces directly to the implant-bone interface and prosthetic components.
Objective: This narrative review synthesizes current knowledge regarding bruxism-related complications in implant-supported rehabilitations and evaluates available management strategies.
Methods: A comprehensive narrative review was conducted using PubMed/MEDLINE, Embase, Web of Science, Scopus, Cochrane Library, and Science Direct databases covering publications from January 1990 to December 2024. Studies investigating bruxism's relationship with dental implant outcomes, clinical complications, and management strategies were included.
Results: Systematic reviews demonstrate that bruxing patients have 2.2-4.7 fold increased implant failure risk compared to non-bruxing patients. Finite element analyses reveal that occlusal splints reduce stress concentration by 33-73% depending on load magnitude. Limited evidence exists regarding the association between bruxism and peri-implant bone loss. Technical complications include prosthetic component fractures, screw loosening, and framework failures. Management strategies include occlusal splint therapy, modified prosthetic designs, strategic implant placement, and comprehensive follow-up protocols.
Conclusions: While bruxism significantly increases the risk of complications in implant-supported rehabilitations, successful outcomes are achievable through comprehensive management approaches. Evidence supports the effectiveness of occlusal splints in stress reduction and splinted prosthetic designs for optimal force distribution. However, the relationship between bruxism and implant complications remains complex, requiring standardized diagnostic criteria and evidence-based treatment protocols.
背景：磨牙是种植体支持康复并发症的重要危险因素。与由牙周韧带缓冲的天然牙齿不同，刚性骨整合连接将过度的磨擦力直接传递给种植体-骨界面和假体部件。目的：本综述综合了目前关于磨牙相关并发症在种植体支持康复中的知识，并评估了可用的管理策略。方法：采用PubMed/MEDLINE、Embase、Web of Science、Scopus、Cochrane Library和Science Direct数据库，对1990年1月至2024年12月的出版物进行综合综述。研究调查磨牙与种植体结果、临床并发症和管理策略的关系。结果：系统综述表明磨牙患者的种植体失败风险比未磨牙患者增加2.2-4.7倍。有限元分析表明，根据载荷大小，咬合夹板可将应力集中降低33-73%。关于磨牙和种植体周围骨质流失之间的关系，证据有限。技术并发症包括假体部件骨折、螺钉松动和框架失效。管理策略包括咬合夹板治疗、改良假体设计、种植体策略性放置和全面的随访方案。结论：磨牙明显增加了种植体支持康复并发症的风险，通过综合管理方法可以获得成功的结果。证据支持咬合夹板在应力减少和夹板假体设计的最佳力分布的有效性。然而，磨牙和种植体并发症之间的关系仍然很复杂，需要标准化的诊断标准和循证治疗方案。
期刊介绍：
BMC Oral Health is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of disorders of the mouth, teeth and gums, as well as related molecular genetics, pathophysiology, and epidemiology.
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