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How Does Parafunctional Activity Affect the Prognosis of an Implant?

Authors: Eric Park, Gary Berkowitz, DDS and Analia Veitz-Keenan, DDS, FAGD

Background: tis, and myofascial pain, which are particu- They examined 106 bruxers with matched
Dental implants have become a very effec- larly important to dentists. Therefore, early 106 non-bruxers. They concluded that
tive treatment for replacing missing teeth assessment and intervention by dentists are bruxers presented a statistically significant
and are an excellent treatment option for essential to improve the patients’ possible greater marginal bone loss over time than
patients. They provide a promising result detrimental results. non-bruxers with p < 0.001. Therefore, the
for esthetic and functional enhancement null hypothesis, which states no statistical-
and even prevent the alveolar bone from As an excessive force, especially nonaxial ly significant association between marginal
resorption. Nonetheless, any possible neg- grinding or clenching movements, is exert- bone loss and bruxism, is rejected.
ative results should always be considered ed on the implant itself, implants are prone
by dental professionals. Some studies have to the risk of failure or complications. Im- The second retrospective cohort study,
shown that the implant failure rate among pact on the implant also is a potential dete- Bruxism, and dental implant treatment
patients is approximately 4%. Although riorating result of bruxism. Several studies complications: a retrospective comparative
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the failure rate seems low, risk factors such have revealed the negative impact of brux- study of 98 bruxer patients and a matched
as periodontal disease, smoking, diabetes, ism on the longevity of dental implants. 8-10 group, by Chrcanovic et al. 2016, evaluated
chronic use of antiresorptive medications One meta-analysis has shown a twofold the relationship between bruxism, implant
such as bisphosphonates, or bruxism may increase in implant failure rate among pa- failure, and mechanical complications.
significantly impact the prognosis of the tients with bruxism. 8 Dental implant failure, by definition, is the
implant. Thus, these risk factors should be total loss of the implant. Mechanical com-
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thoroughly evaluated by providers. Studies In this review article, we investigate the plications are defined as the failures of one
have shown that these factors are respon- impact of bruxism on dental implants and or more components of an implant system.
sible for statistically significant increases surrounding structures.
in implant failure and complication rates. Methodology: The study demonstrated that out of those
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This article focuses on the impact of brux- Electronic databases such as PubMed and 98 bruxers, 25 patients experienced at least
ism on dental implants as well as related DOSS were utilized for this review. one implant failure, whereas out of 98
biological and mechanical complications. non-bruxers, only 11 patients experienced
at least one implant failure. The odds ratio
The main goal of this review was to assess
Bruxism, a parafunctional activity, is de- the impact of bruxism on dental implants. is 2.71, with a p-value of 0.01. The result
fined as repetitive masticatory muscle ac- About 2,400 articles discussed the associ- infers that if a patient experiences at least
tivity characterized by clenching or grind- ation between parafunctional habits, brux- one implant failure, the patient is 2.71 times
ing of the teeth and/or bracing or thrusting ism, and implants. Filtration that included more likely to have a history of bruxism.
of the mandible and is specified as either English, human subjects, and implants fur- FOR
sleep bruxism or awake bruxism. A sys- ther condensed the finding to 955 articles. Moreover, bruxers experienced more
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tematic review suggests that the preva- After duplication removal and screening, implant mechanical complications than IMMEDIATE
lence of awake bruxism among adults is three studies were included to review the non-bruxers with an odds ratio above 1 RELEASE
8% to 31.4% and sleep bruxism is 12.8% ± impact of bruxism on implants: two retro- with p value less than 0.001.
3.1%, whereas among children, it is 14% spective cohort studies and one systematic The third study, Does Bruxism Contribute
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to 20%. Awake bruxism has a female pre- review. to Dental Implant Failure? A Systematic
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dilection, while sleep bruxism didn’t show Review and Meta-Analysis by Yi Zhou et al. New York
gender preference. The cause of bruxism To appraise the retrospective observational 2015, included seven retrospective studies
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is widely unknown, but several researchers studies, validated critical appraisal forms based on their inclusion criteria. The study Dentist
have discovered several factors involved were used to assess the methodology and assessed the methodological quality of the Elected
in bruxism. For instance, genetics play a quality of the articles as well as to highlight studies, such as studies’ selection, compa-
role as it is often found to run in the fam- the potential biases and limitations that rability, and outcomes. All retrospective AIP President
ily. Psychosocial problems such as anxiety may have been present. Each article was studies revealed moderate to high quality.
or stress, or medications such as SSRI, divided into study type, intervention and RENO, NEVADA •
dopamine modulators, TCA, alcohol, or control, primary outcomes, key results, and A systematic review has shown that out of August 13, 2023—
cocaine that cause disturbance in the do- overall appraisal and quality. 441 implants of bruxers, 107 implants ex- Dr. Robert M.
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paminergic pathway also play significant perienced either various types of mechan- Peskin, a dentist
roles in bruxism, and patients with higher Results: ical complications or implant failure. In based in Garden City, New York, was
stress sensitivity or depression or substance The first retrospective cohort study, Mar- contrast, only 88 implants of 1166 implants elected president of the American
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users report a higher incidence of bruxism. ginal bone loss around dental implants: of non-bruxers experienced either various Institute of Parliamentarians (AIP) on
comparison between matched groups of mechanical complications or implant fail- Thursday, August 10, 2023. He was in-
Definite diagnosis of bruxism requires sev- bruxer and non-bruxer patients: A retro- ure. The odds ratio is 4.72, and the p-value stalled on Saturday, August 12 during the
eral methods, including questionnaires, spective case–control study, by Chrcanovic is less than 0.00001. These results indicate th
clinical examinations, masticatory muscle et al. 2022, compared the marginal bone that if an implant undergoes implant failure Closing Ceremonies of AIP’s 64 Annual
electromyographic recordings, or poly- loss after implant placement between the or mechanical complications, it is almost Session.
somnography. Even though bruxism is not bruxers and non-bruxers. The article’s clin- five times more likely to be an implant of
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a severe problem, it may render quality of ical question was, “Do bruxers undergoing a bruxer. AIP is a not-for-profit educational organi-
life decreasing problems such as trismus, implant-prosthetic rehabilitation present a zation founded in 1958 for the advance-
TMJ pain, headache, attrition, inflamma- higher marginal bone loss over time com- ment of parliamentary procedure. Its
tion around the PDL, tooth mobility, arthri- pared to patients not presenting bruxism?”

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