Rehabilitation planning

When an implant supported rehabilitation is considered in bruxers, occlusal examination is essential. Premature and posterior contacts during mandibular excursions increase the potential for excessive loads on teeth and implants .Thus, it is important to emphasize the importance of clinical evaluation and accurate anamnesis to identify the disease and hence, to improve the longevity of implant-supported rehabilitation treatment . Regarding doubts about the load time determination, though a recent systematic review, has evaluated the load protocols for dental implants and concluded that there is no predictability in the use of immediate or early loading on dental implants, it is recommended to use caution when using any of these techniques, especially in bruxers. Although there is no conclusive scientific evidence that bruxism causes overload on dental implants and their superstructure, professionals should proceed cautiously when planning implant supported restorations in bruxers, mainly due to the severity of possible complications. All preventive measures should be aimed at minimizing the forces that are applied to implants .

A bruxism patient presents an increased risk of implant fracture over time since the magnitude of forces increases as the muscles become stronger. Therefore, when a source of additional load on the implant is identified, the treatment plan must be changed to minimize adverse effects on the alveolar bone, implant and definitive restoration .