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Evaluation of mandibular bone density in bruxers: the value of panoramic radiographs

Abstract

Objectives

This study aimed to establish a difference in mandibular bone density between bruxer and non-bruxer patients, based on panoramic radiographs.

Methods

Panoramic radiographs of bruxer and non-bruxer patients were analyzed with ImageJ®. Several radiological determinants were studied on the patients' panoramic radiographs: gray values of cancellous bone and cortical bone, and bony exostoses at the mandibular angle.

Results

Thirty-seven bruxers and forty-seven non-bruxers were included in the study.

A statistically significant difference (p < 0.05) was noted in the cancellous to cortical bone ratios of bruxers and non-bruxers: the density of cancellous bone was greater in bruxers than in non-bruxers.

The number of bony exostoses at the mandibular angle was significantly higher in bruxers (p < 0.05).

Conclusions

This study obtained radiological determinants of bruxism from panoramic radiographs. Further studies are needed to supplement this preliminary approach, especially via the analysis of three-dimensional imaging to overcome the limitations of panoramic radiography.

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References

  1. Lobbezoo F, Ahlberg J, Raphael KG, Wetselaar P, Glaros AG, Kato T, et al. International consensus on the assessment of bruxism: report of a work in progress. J Oral Rehabil. 2018;45:837–44. https://doi.org/10.1111/joor.12663.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Manfredini D, Ahlberg J, Wetselaar P, Svensson P, Lobbezoo F. The bruxism construct: from cut-off points to a continuum spectrum. J Oral Rehabil. 2019;46:991–7. https://doi.org/10.1111/joor.12833.

    Article  PubMed  Google Scholar 

  3. Manfredini D, Colonna A, Bracci A, Lobbezoo F. Bruxism: a summary of current knowledge on aetiology, assessment and management. Oral Surg. 2020;13:358–70.

    Article  Google Scholar 

  4. Lumetti S, Ghiacci G, Macaluso GM, Amore M, Galli C, Calciolari E, et al. Tardive dyskinesia, oral parafunction, and implant-supported rehabilitation. Case Rep Dent. 2016. https://doi.org/10.1155/2016/7167452.

    Article  PubMed  PubMed Central  Google Scholar 

  5. de Baat C, Verhoeff M, Ahlberg J, Manfredini D, Winocur E, Zweers P, et al. Medications and addictive substances potentially inducing or attenuating sleep bruxism and/or awake bruxism. J Oral Rehabil. 2021;48:343–54. https://doi.org/10.1111/joor.13061.

    Article  PubMed  Google Scholar 

  6. Melo G, Duarte J, Pauletto P, Porporatti AL, Stuginski-Barbosa J, Winocur E, et al. Bruxism: an umbrella review of systematic reviews. J Oral Rehabil. 2019;46:666–90. https://doi.org/10.1111/joor.12801.

    Article  PubMed  Google Scholar 

  7. Goldstein G, DeSantis L, Goodacre C. Bruxism: best evidence consensus statement. J Prosthodont. 2021;30:91–101. https://doi.org/10.1111/jopr.13308.

    Article  PubMed  Google Scholar 

  8. Newman HN. Attrition, eruption, and the periodontium. J Dent Res. 1999;78:730–4. https://doi.org/10.1177/00220345990780030401.

    Article  PubMed  Google Scholar 

  9. Lang NP, Bartold PM. Periodontal health. J Periodontol. 2018;89(Suppl 1):S9-16. https://doi.org/10.1002/JPER.16-0517.

    Article  PubMed  Google Scholar 

  10. Ré JP, Orthlieb JD. “Periofunctional” approach [Approche « parofonctionnelle »]. J Parodontol. 2020;39:41–8.

    Google Scholar 

  11. Gross M, Gracis S, Gamborena I, Meyenberg K, Shifman A, Nissan J. The science and art of occlusion and oral rehabilitation. Batavia: Quintessence publishing; 2015.

    Google Scholar 

  12. Wolff JD. The law of transformation of the bones [Das Gesetz der Transformation der Knochen]. Berlin: Verlag von Auguste Hirschwald; 1892.

    Google Scholar 

  13. Botelho J, Machado V, Proença L, Rua J, Martins L, Alves R, et al. Relationship between self-reported bruxism and periodontal status: Findings from a cross-sectional study. J Periodontol. 2020;91:1049–56. https://doi.org/10.1002/JPER.19-0364.

    Article  Google Scholar 

  14. Landa J, Rich A, Finkelman M. Confirming nasal airway dimensions observed on panoramic and posterior-anterior cephalometric radiographs using an acoustic rhinometer. Eur Arch Paediatr Dent. 2010;11:115–21. https://doi.org/10.1007/BF03262726.

    Article  PubMed  Google Scholar 

  15. Chugh NK, Bhattacharyya J, Das S, Ghosh S, Dutta K, Goel P. Use of digital panoramic radiology in presurgical implant treatment planning to accurately assess bone density. J Prosthet Dent. 2016;116:200-205.e1. https://doi.org/10.1016/j.prosdent.2016.01.017.

    Article  PubMed  Google Scholar 

  16. Kış HC, Güleryüz GA. Evaluation of the peri-implant bone trabecular microstructure changes in short implants with fractal analysis. Int J Implant Dent. 2020. https://doi.org/10.1186/s40729-020-00209-7.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Tosoni GM, Lurie AG, Cowan AE, Burleson JA. Pixel intensity and fractal analyses: detecting osteoporosis in perimenopausal and postmenopausal women by using digital panoramic images. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;102:235–41. https://doi.org/10.1016/j.tripleo.2005.08.020.

    Article  PubMed  Google Scholar 

  18. Lurie A, Tosoni GM, Tsimikas J, Walker F. Recursive hierarchic segmentation analysis of bone mineral density changes on digital panoramic images. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;113:549-558.e1. https://doi.org/10.1016/j.oooo.2011.10.002.

    Article  PubMed  Google Scholar 

  19. Alapati S, Reddy RS, Tatapudi R, Kotha R, Bodu NK, Chennoju S. Identifying risk groups for osteoporosis by digital panoramic radiography. Contemp Clin Dent. 2015;6:S253-257. https://doi.org/10.4103/0976-237X.166833.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Ayed MS, Alsharif AF, Divakar DD, Jhugroo C, Alosaimi B, Mustafa M. Evaluating the possible association between systemic osteoporosis and periodontal disease progression in postmenopausal women. Dis Mon. 2019;65(6):193–215. https://doi.org/10.1016/j.disamonth.2018.11.001.

    Article  PubMed  Google Scholar 

  21. HAS. Cone beam computerized tomography [Tomographie volumique à faisceau conique de la face]. 2009. https://www.has-sante.fr/upload/docs/application/pdf/2009-12/texte_court_cone_beam_2009-12-28_17-27-51_224.pdf. Accessed 10 Jan 2022.

  22. Autorité de sûreté nucléaire. Main indications for panoramic radiographs [Principales indications des radiographies panoramiques]. 2021. https://www.asn.fr/Informer/Actualites/Principales-indications-des-radiographies-panoramiques. Accessed 10 Jan 2022.

  23. Isman O. Evaluation of jaw bone density and morphology in bruxers using panoramic radiography. J Dent Sci. 2021;16:676–81. https://doi.org/10.1016/j.jds.2020.09.008.

    Article  PubMed  Google Scholar 

  24. Antunes JJ, Almeida SA, de Monteiro RMP C, Martins AM. Idiopathic masseter muscle hypertrophy: a case report. Einstein (Sao Paulo). 2019;17(2):eAI4506. https://doi.org/10.31744/einstein_journal/2019AI4506.

    Article  PubMed Central  Google Scholar 

  25. Kebede B, Megersa S. Idiopathic masseter muscle hypertrophy. Ethiop J Health Sci. 2011;21:209–12.

    PubMed  PubMed Central  Google Scholar 

  26. Gulec M, Tassoker M, Ozcan S, Orhan K. Evaluation of the mandibular trabecular bone in patients with bruxism using fractal analysis. Oral Radiol. 2021;37(1):36–45. https://doi.org/10.1007/s11282-020-00422-5.

    Article  PubMed  Google Scholar 

  27. PadmajaSatheeswarakumar L, Elenjickal TJ, Ram SKM, Thangasamy K. Assessment of mandibular surface area changes in bruxers versus controls on panoramic radiographic images: a case control study. Open Dent J. 2018;12:753–61. https://doi.org/10.2174/1745017901814010753.

    Article  Google Scholar 

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Correspondence to Estelle Casazza.

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The authors declared that they have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by the any of the authors. RGPD-APHM registry #2020-149.

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Casazza, E., Ballester, B., Philip-Alliez, C. et al. Evaluation of mandibular bone density in bruxers: the value of panoramic radiographs. Oral Radiol (2022). https://doi.org/10.1007/s11282-022-00612-3

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  • DOI: https://doi.org/10.1007/s11282-022-00612-3

Keywords

  • Bone density
  • Bruxism
  • Exostoses
  • Mandible
  • Panoramic radiograph