Occlusal Overload and Periodontitis: Integrating Mechanisms, Clinical Evidence, and Emerging Perspectives-A Scoping...

Area of Science:

• Periodontology
• Biomaterials Science
• Inflammatory Pathways

Background:

• Occlusal trauma's role in periodontitis is debated.
• Excessive occlusal forces may accelerate periodontal breakdown via inflammatory and proteolytic mechanisms.

Purpose of the Study:

• To review evidence on the interplay between occlusal trauma and periodontal degradation.
• To synthesize findings from clinical, animal, and in vitro studies.

Main Methods:

• Scoping review of studies from 2014-2025 using PRISMA-ScR guidelines.
• Searched PubMed, Web of Science, Scopus, Embase, and Cochrane Library.
• Included clinical trials, observational studies, animal models, and in vitro experiments.

Main Results:

• Eighteen studies met inclusion criteria (8 clinical, 7 animal, 3 in vitro).
• Occlusal adjustment with periodontal therapy improved outcomes (reduced probing depth, bleeding on probing, bacterial load).
• Mechanical loading amplified inflammation (IL-6, TNF-α), activated signaling pathways (IKK/NF-κB, YAP), and suppressed osteogenic differentiation, increasing MMP-8 release.

Conclusions:

• Occlusal trauma modifies periodontitis progression in susceptible individuals.
• Integrating occlusal assessment, active MMP-8 analysis, and targeted therapies may enhance periodontal treatment.
• Selective occlusal intervention may optimize benefit-to-burden ratio; further research is needed.