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

Occlusal trauma functions as a modifying factor that may exacerbate periodontitis progression in susceptible individuals, though it should not be considered an initiating cause of disease. The integration of occlusal assessment, active MMP-8 (aMMP-8) biomarker analysis, and targeted therapies may enhance periodontal treatment outcomes. However, the modest effect sizes observed in clinical studies suggest that selective rather than routine occlusal intervention may optimize the benefit-to-burden ratio. Further longitudinal and interventional studies are warranted to validate these findings and establish clinical guidelines.