BRUKSİZMİN TANISINDA RADYOLOJİK VERİLERİN ROLÜ: MANDİBULAR AÇI DEĞİŞİKLİKLERİ ÜZERİNE RETROSPEKTİF BİR ÇALIŞMA

Year 2024, Volume: 26 Issue: 3, 368 - 371, 24.12.2024

Berkan Altay , Elif Çoban

Abstract

Amaç: Bu çalışma, bruksizmin mandibula köşesinde meydana getirdiği anatomik değişimlerin radyografik değerlendirmesine yönelik mevcut bulguları analiz etmeyi; özbildirim ve klinik muayenenin yanı sıra bu bulguların klinik tanıda önemini vurgulamayı amaçlamaktadır.
Gereç ve Yöntemler: Retrospektif kesitsel bir analiz olarak yapılandırılmış olan bu çalışma, Kırıkkale Üniversitesi Diş Hekimliği Fakültesi Ağız, Diş ve Çene Cerrahisi Anabilim Dalı'nda düzenli olarak tedavi gören hastaların panaromik radyografileri değerlendirildi. Grup 1: Bruksizme sahip hastalar, Grup 2: Bruksizme sahip olmayan hastalar. Her gruptaki hastaların yaş ve cinsiyet gibi demografik verileri ile panaromik röntgen üzerindeki masseter ve medial pterygoid kaslarının yapışma yerindeki superior ve inferior açılar kaydedildi ve değerlendirildi.
Bulgular: Araştırmanın bulgularına göre, hastaların yaş ortalaması 42.22±16.29 olarak hesaplanmıştır. Hastaların %43’ü erkek, %57’sı kadındır. Grup 1 ve Grup 2’nin sağ ve sol masseter kas açılarında istatistiksel farklılıklar gözlenmiştir. Sağ süperior masseter açısında Grup 1’in ortalaması 167.3±7.11 iken, Grup 2’nin ortalaması 169.96±5.98 olarak bulunmuş ve bu fark anlamlı çıkmıştır (p<0.05). Sağ inferior masseter açısında ise Grup 1’de 137.66, Grup 2’de 165.16±5.1 olarak ölçülmüş, aradaki fark istatistiksel olarak anlamlı bulunmuştur. Sol süperior masseter açısında Grup 1’in ortalaması 169.96±5.95, Grup 2’nin ortalaması 168.95±5.85 olarak bulunmuş ve ve bu fark anlamlı çıkmıştır (p<0.05). Sol inferior masseter açısında ise Grup 1’in ortalaması 165.16±3.43, Grup 2’nin ortalaması 166.57±5.51 olup, bu değerler arasında anlamlı bir fark bulunmuştur (p<0.05).
Sonuç: Öz bildirim ve klinik muayeneye ek olarak, radyolojik verilerle belirlenen morfolojik değişiklikler, bruksizmin tanısında ek bir gösterge olarak kullanılabilir. Bu bilgiler, özellikle hastaların bu parafonksiyonel aktivitenin farkında olmadıkları durumlarda, hem tanı koymada hem de hastaları bilgilendirmede faydalı olabilir.

Keywords

Bruksizm, kemiğin yeniden şekillendirilmesi, mandibula, panoramik radyografi

The Role of Radiological Data in the Diagnosis of Bruxism: A Retrospective Study on Changes in the Mandibular Angle

Abstract

Objective: This study aims to analyze existing findings on the anatomical changes in the mandibular angle caused by bruxism, with a focus on the radiographic assessment of these alterations. Additionally, it seeks to highlight the significance of these findings in clinical diagnosis alongside self-reports and clinical examination.
Material and Methods: This retrospective cross-sectional study evaluated panoramic radiographs of patients regularly treated at the Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Kırıkkale University. Group 1 consisted of patients diagnosed with bruxism, while Group 2 comprised patients without bruxism. Demographic data, such as age and gender, were recorded for each group. Radiographic angles at the attachment sites of the masseter and medial pterygoid muscles—specifically, the superior and inferior angles—were assessed and measured on panoramic radiographs.
Results: The findings indicated that the average age of patients was 42.22±16.29 years. Of the participants, 43% were male, and 57% were female. Statistically significant differences were observed in the right and left masseter muscle angles between Groups 1 and 2. The average right superior masseter angle was 167.3±7.11 in Group 1, compared to 169.96 ±5.98 in Group 2, with the difference being statistically significant (p<0.05). For the right inferior masseter angle, the average measurement was 137.66 in Group 1 and 165.16±5.1 in Group 2, also showing a significant statistical difference. In the left superior masseter angle, Group 1's average was 169.96±5.95, while Group 2's was 168.95±5.85, with the difference deemed significant (p<0.05). Similarly, for the left inferior masseter angle, Group 1's mean was 165.16±3.43, and Group 2's was 166.57±5.51, with a statistically significant difference observed (p<0.05).
Conclusion: Morphological changes detected through radiological data, in addition to self-reporting and clinical examination, can serve as supplementary indicators in the diagnosis of bruxism. This additional information can be particularly beneficial when patients are unaware of the presence of this parafunctional activity, aiding both in diagnosis and in patient education.

Keywords

Bruxism, bone remodeling, mandible, panoramic radiography

References

• Lobbezoo F, Ahlberg J, Glaros AG, et al. Bruxism defined and graded: an international consensus. J Oral Rehabil. 2013;40(1):2–4.
• Manfredini D, Winocur E, Guarda-Nardini L, Paesani D, Lobbezoo F. Epidemiology of bruxism in adults: A systematic review of the literature. J Orofac Pain. 2013;27(2):99–110.
• Weijs WA, Hillen B. Cross-sectional areas and estimated intrinsic strength of the human jaw muscles. Acta Morphol Neerl Scand. 1985;23(3):267–274.
• Türp JC, Simonek M, Dagassan D. Bone apposition at the mandibular angles as a radiological sign of bruxism: a retrospective study. BMC Oral Health. 2021;21(1):537.
• Tsiggos N, Tortopidis D, Hatzikyriakos A, Menexes G. Association between self-reported bruxism activity and occurrence of dental attrition, abfraction, and occlusal pits on natural teeth. J Prosthet Dent. 2008;100(1):41–46.
• Rompré PH, Daigle-Landry D, Guitard F, Montplaisir JY, Lavigne GJ. Identification of a sleep bruxism subgroup with a higher risk of pain. J Dent Res. 2007;86(9):837–842.
• Carra MC, Huynh N, Morton P, et al. Prevalence and risk factors of sleep bruxism and wake-time tooth clenching in a 7- to 17-yr-old population. Eur J Oral Sci. 2011;119(5):386–394.
• Mıchelottı A, Cıoffı I, Festa P, Scala G, Farella M. Oral parafunctions as risk factors for diagnostic TMD subgroups. J Oral Rehabil. 2010;37(3):157–162.
• Stuginski-Barbosa J, Porporatti AL, Costa YM, Svensson P, Conti PCR. Agreement of the ınternational classification of sleep disorders criteria with polysomnography for sleep bruxism diagnosis: A preliminary study. J Prosthet Dent. 2017;117(1):61–66.
• de Baat C, Verhoeff MC, Ahlberg J, et al. Medications and addictive substances potentially inducing or attenuating sleep bruxism and/or awake bruxism. J Oral Rehabil. 2021;48(3):343–354.
• Lobbezoo F, Ahlberg J, Raphael KG, et al. International consensus on the assessment of bruxism: Report of a work in progress. J Oral Rehabil. 2018;45(11):837–844.
• Nishio C, Tanimoto K, Hirose M, et al. Stress analysis in the mandibular condyle during prolonged clenching: a theoretical approach with the finite element method. Proc Inst Mech Eng H. 2009;223(6):739–748.
• Nykänen L, Manfredini D, Lobbezoo F, Kämppi A, Bracci A, Ahlberg J. Assessment of awake bruxism by a novel bruxism screener and ecological momentary assessment among patients with masticatory muscle myalgia and healthy controls. J Oral Rehabil 2024;51(1):162–169.
• Raphael KG, Janal MN, Sirois DA, et al. Validity of self-reported sleep bruxism among myofascial temporomandibular disorder patients and controls. J Oral Rehabil. 2015;42(10):751–758.
• Palinkas M, Nassar MSP, Cecílio FA, et al. Age and gender influence on maximal bite force and masticatory muscles thickness. Arch Oral Biol. 2010;55(10):797–802.
• Koç D, Doğan A, Bek B. Effect of gender, facial dimensions, body mass index and type of functional occlusion on bite force. J Appl Oral Sci. 2011;19(3):274–279.
• Teng S, Herring SW. Compressive loading on bone surfaces from muscular contraction: an in vivo study in the miniature pig, Sus scrofa. J Morphol. 1998;238(1):71–80.
• Panagiotopoulou O, Iriarte-Diaz J, Mehari Abraha H, et al. Biomechanics of the mandible of Macaca mulatta during the power stroke of mastication: Loading, deformation, and strain regimes and the impact of food type. J Hum Evol. 2020;147:102865.
• Melo G, Duarte J, Pauletto P, et al. Bruxism: An umbrella review of systematic reviews. J Oral Rehabil. 2019;46(7):666–690.