The Impact of Bruxism on the Success and Longevity of Dental Restorations and Implants: A Systematic Review

Abstract

Bruxism, characterized by repetitive jaw-muscle activity involving teeth clenching and grinding, generates occlusal forces far exceeding normal functional activities. This systematic review aims to assess the impact of bruxism on the success and longevity of dental restorations and implants. A systematic review was conducted following PRISMA 2020 guidelines. Electronic searches were performed in PubMed/MEDLINE, Web of Science, Scopus, Cochrane Library, and Science Direct for studies published between January 2000 and December 2025. Studies reporting outcomes of dental implants or restorations in patients with bruxism were included. Twenty-seven studies met the inclusion criteria. Meta-analyses demonstrated that bruxism significantly increases implant failure risk (OR 2.2-2.3, p<0.001). Mechanical complications predominate, including implant fractures, screw loosening, and ceramic chipping, occurring 2-10 times more frequently in bruxers. Anterior ceramic veneers showed dramatically increased failure risk (HR 7.74), while monolithic zirconia demonstrated favorable short-term outcomes. A critical geographical evidence gap was identified, with no clinical studies from Libya investigating bruxism and dental outcomes. Bruxism approximately doubles implant failure risk and substantially increases mechanical complications. Evidence-based management includes systematic screening, patient counseling, modified treatment planning, appropriate material selection, and occlusal splint therapy. Urgent research is needed in Libyan populations to verify the applicability of global evidence and guide region-specific clinical recommendations