Risk of implant failure in patients with bruxism

Introduction: Bruxism is a pathology considered by many authors a risk factor for dental implant placement. Aim: This literature review aims to answer the question: "Does implant placement in patients with bruxism represents a higher risk of implant failure, in comparison with patients without bruxism?" Methods: A search was conducted with the keywords (bruxism OR clenching) AND (implant fracture OR implant failure OR implant survival OR implant mechanical complications), in electronic databases, without time restrictions and considering articles in english, portuguese and spanish. The results were analyzed according to their abstract and the following inclusion criteria: systematic reviews and meta-analysis, randomized controlled trials, prospective and retrospective studies (case series including more than 10 patients). In vitro or animal studies were dismissed. No criteria was defined about population study or follow up. Results: Of the 105 articles found 9 of which were eligible for inclusion. Three of these studies found a positive association between bruxism and the risk of implant failure, two a negative relation and the remaining considered this relation questionable. The disparity of results may be due to several factors, such as study design and criteria applied for the diagnosis of bruxism. Conclusion: The causal relation studied remains controversial. Further investigations are necessary for a more objective answer. Clinical implications: The possible association between implant failure and bruxism requires a detailed diagnosis of the existing parafunction, in order to establish proper management of the problem during and after rehabilitation. Keywords: dental implants, bruxism, implant-supported rehabilitation, occlusion