Bone apposition at the mandibular angles as a radiological sign of bruxism: a retrospective study

Jens Christoph Türp,Michelle Simonek,Dorothea Dagassan

doi:10.1186/s12903-021-01804-9

Abstract

BackgroundThe main objective of this investigation was to determine on panoramic radiographs the prevalence of macroscopically visible alterations (bone apposition in combination with directional change) in the mandibular angle region in bruxism patients. Another aim was to describe and detect different morphological characteristics of the jaw angles.MethodsTwo hundred panoramic radiographs were studied: 100 images of adults with clinically diagnosed bruxism (73 women, 27 men, age range 21–83 years), 100 images of a comparison group consisting of adolescents (66 girls, 34 boys, age range 12–18 years).ResultsThe morphological changes of the 400 jaw angles could be classified into four degrees. In the adult group, almost half of mandibular angles showed bone apposition. Conversely, the prevalence in the control group was zero. The localization of the appositions corresponds to the insertions of the masseter and medial pterygoid muscles at the mandibular angle.ConclusionsThe bone apposition at the mandibular angles should be interpreted as a functional adaptation to the long-term increased loads that occur during the contraction of the jaw closing muscles due to bruxism. Hence, radiologically diagnosed bone apposition may serve as an indication or confirmation of bruxism.

Highlights

IntroductionThe main objective of this investigation was to determine on panoramic radiographs the prevalence of macroscopically visible alterations (bone apposition in combination with directional change) in the mandibular angle region in bruxism patients
The main objective of this investigation was to determine on panoramic radiographs the prevalence of macroscopically visible alterations in the mandibular angle region in bruxism patients
In contrast to anamnestic information and data obtained from the clinical examination, instrumental diagnostic procedures have the disadvantage that they are less frequently available, their use is associated with cost and time, and not every patient gives consent for this type of assessment

Summary

Introduction

The main objective of this investigation was to determine on panoramic radiographs the prevalence of macroscopically visible alterations (bone apposition in combination with directional change) in the mandibular angle region in bruxism patients. Current strategies for assessing the presence of bruxism are based on (a) self-report by the individual, (b) clinical examination, and (c) instrumental approaches such as electromyographic recordings, including polysomnography and/or audio/video recordings [13]. Together, they form a grading system with increasing likelihood of a valid diagnosis of bruxism. In contrast to anamnestic information and data obtained from the clinical examination, instrumental diagnostic procedures have the disadvantage that they are less frequently available, their use is associated with cost and time, and not every patient gives consent for this type of assessment

Methods

Results

Discussion

Conclusion