Implants Under Pressure: Risk Assessment, Material Selection, and Occlusal Management in Bruxism-Affected Prosthodontic Rehabilitation: A Literature Review

Review Article

Abstract

Dental implants represent a predictable and well-documented option for the rehabilitation of partially or completely
edentulous patients; however, biological and mechanical complications remain clinically relevant concerns that
may compromise long-term outcomes. Among the contributing risk factors, bruxism has attracted increasing
attention due to its association with excessive and repetitive occlusal loading on implant components and periimplant
bone. Unlike natural teeth, osseointegrated implants lack a periodontal ligament, making them more
susceptible to parafunctional force transmission. Evidence on the impact of bruxism on implant survival, mechanical
complications, and peri-implant tissue health remains heterogeneous. This narrative review examines current
evidence on biomechanical consequences of bruxism, patient risk stratification, restorative material selection, and
occlusal management strategies, with the goal of informing a risk-stratified, protocol-driven approach to implant
prosthodontics in bruxism-affected patients.