Longevidade de implantes dentários em pacientes com bruxismo: uma revisão sistemática e meta-análise

Abstract

Dental implants are increasingly being used to restore the absence of dental elements, partial or total. However, some risk factors can compromise the success of implant treatment. Bruxism, which is considered a parafunctional muscular activity that can cause occlusal overload on the support structures of dental implants, can thus compromise their longevity. The objective of this study was to evaluate the association between bruxism and the risk of dental implant complications and failures. The systematic review was registered in PROSPERO, and two independent reviewers searched the PubMed/MEDLINE, Embase, Web of Science, Scopus, and ProQuest databases with the aid of the 'Rayyan QCRI' program. The meta-analysis was carried out using the RevMan 5.4 program, and the quality of the studies was assessed using the NIH assessment tool. A total of 21 studies were included, totaling 5069 patients. A total of 14,921 implants were installed, 2908 in patients with bruxism and 12,013 in controls. From this systematic review, we can see that patients with bruxism had a significantly higher chance of implant loss compared to the control group, with an odds ratio (OR) of 2.77 (Confidence Interval [CI]: 1.58 to 4.66). With regard to complications, there was also a higher risk of failure and complications for patients with bruxism (OR: 2.27; CI: 1.46 to 3.51;). With regard to marginal bone loss, it was not possible to consider a meta-analysis, but three studies that evaluated bone loss in patients with bruxism found a greater predisposition to loss for these patients than when compared to patients without this disorder. We can therefore conclude that bruxism is a risk factor when it comes to installing dental implants. More standardized and controlled studies are needed, as well as the importance of looking for effective interventions for this disorder concomitant with implant planning by the dental surgeon.