Bruxism

Bruxism is the involuntary grinding or clenching of teeth, most commonly during sleep (sleep bruxism) but also sometimes when awake (awake bruxism). It generates forces many times greater than normal chewing — sometimes exceeding 100kg — which can cause significant damage to natural teeth, restorations, and implants.

Why it matters for implants

Unlike natural teeth, implants have no periodontal ligament to absorb and distribute forces. Excessive grinding forces are transmitted directly to the crown, abutment, implant, and surrounding bone. This can lead to:

• Fracture of the porcelain or ceramic crown
• Loosening of the abutment screw
• Implant fixture fracture (rare but serious)
• Bone loss around the implant

Management

Patients with confirmed bruxism are typically advised to wear a custom-made occlusal splint (night guard) to distribute forces. Implant crowns for bruxist patients may be made from more fracture-resistant materials. In severe cases, bruxism may influence whether implants are the most appropriate treatment.

Treatment

While there is no cure for bruxism, it can be managed with occlusal splints, stress reduction, physiotherapy, and in some cases Botox injections into the masseter muscles to reduce grinding forces.