Introduction: Bruxism is increasingly recognized as a psychosomatic condition mediated by stress, anxiety, and sleep disturbances, generating sustained non-physiological occlusal forces that compromise the stability and longevity of dental implants. This narrative review with integrated pilot data synthesizes the causal pathway linking psychological factors to bruxism and its impact on implant outcomes, advocating for an interdisciplinary model of prevention and management.
Methods: A narrative review was conducted using PubMed, Scopus, and Cochrane Library (2000–2025) with keywords including bruxism, dental implants, psychosomatic, stress, anxiety, sleep, biomechanics, implant failure, digital dentistry, artificial intelligence, and interdisciplinary management. Peer-reviewed clinical studies, case series, and technical reports were analyzed. Inclusion criteria were studies addressing psychosomatic or biomechanical aspects of bruxism in relation to implants; exclusion criteria were non-peer-reviewed or non-clinical reports. Pilot data from 15 patients with bruxism and implant-supported restorations (12-month follow-up) were reviewed, integrating psychological assessment, dental examination, and sleep medicine evaluation. Digital tools, including finite element analysis and AI-based occlusal monitoring, were considered.
Results: Evidence shows a strong association between psychosocial stress, anxiety disorders, and sleep disturbances with bruxism. Mechanical complications (screw loosening, veneer and framework fractures) and biological complications (peri-implant bone loss, implant failure) were identified. Early studies indicate that intraoral force sensors, AI-based scan analysis, and polysomnography enable the early detection of overload and prosthetic compromise. Interdisciplinary interventions—occlusal splints, cognitive-behavioral therapy, stress reduction, and sleep medicine—reduce complications. Studies remain small and heterogeneous; consistent trends support the association between psychosocial stressors, bruxism, and implant outcomes.
Conclusions: Psychological determinants threaten implant survival via biomechanical overload. Proactive management requires interdisciplinary collaboration. The proposed model—integrating dentists, psychologists, and sleep medicine physicians, supported by digital monitoring—represents not only a clinical recommendation but also a research agenda. Future randomized trials and validation of AI tools are essential to strengthen evidence and improve long-term outcomes.
