Relationship between bruxism and mandibular bone modifications based on medical imaging: a scoping review.

OBJECTIVES: This scoping review aimed to assess the current state of knowledge regarding the relationship between bruxism and changes in density or volume of mandibular bone, based on medical imaging. METHODS: Literature review was conducted following the PRISMA-ScR protocol. PubMed, Web of Science and Cochrane library databases were searched for peer-reviewed articles by two blinded reviewers. Studies based on the evaluation of mandibular bone density and/or bone volume with imaging examination in adult patients were examined. The selected articles were summarized in PICOS tables and assessed for methodological quality. RESULTS: Nine articles were included, according to the inclusion criteria. They showed that bruxer patients had more bony exostoses of the mandibular angle, smaller condyles, and morphological changes for cancellous and cortical mandibular bone compared to non-bruxer patients. CONCLUSION: Bruxism seems to induce morphological and anatomical changes in the different regions of the mandibular bone (condyles, mandibular angle, mandible body). Given the heterogeneity of the included studies, these results should be interpreted with caution. Further studies are needed to support these results, in particular via the analysis of three-dimensional imaging to overcome the limitations of panoramic radiograph.

Oral Care in Kindler Syndrome: 7-Year Follow-up of 2 Brothers.

BACKGROUND: Kindler poikiloderma is an inherited autosomal genodermatosis characterized by blistering of the epidermis and mucosae. Its prevalence is unknown. CASE REPORT: We monitored two brothers suffering from this pathology. Oral manifestations mainly take the form of periodontal lesions. In our patients we noted gingivitis progressing to periodontitis as follow-up care was not effective. We also diagnosed enamel hypoplasia, described more rarely in this pathology. CONCLUSION: Periodontitis in Kindler Syndrome responds to maintenance therapy, but the absence of surveillance is penalized by a deterioration in periodontal condition and complication of management. All restorative, endodontic, surgical, periodontal and orthodontic treatments should be performed with appropriate precautions.

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

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.

Suitability of Reusing Pre-Doctoral Student Activity Data from an Educational Information System for Quality Measures of Caries Risk.

Dental caries management requires individualized follow-up and prophylaxis based on patients' caries risk (PCR). In large pre-doctoral clinics, the use of institutional quality measures (QMs) is essential to control the quality of patient follow-up and to evaluate the need for improvement measures. The aim of this retrospective study was to evaluate the suitability of reusing student activity data for the development of QMs of caries risk. Two approaches for predicting PCR using student activity data were evaluated and compared. The first approach used the procedure codes recommended by the Dental Quality Alliance and the second used these same codes along with three educational codes. The sensitivity, specificity, overall accuracy of the two approaches were evaluated. A Receiver Operating Characteristic (ROC) curve analysis was carried out, and the areas under the ROC curve of the two approaches were compared using Delong's test. A two-tailed P value ≤0.05 was considered statistically significant. While the two approaches were able to correctly predict PCR, the approach using both procedure and educational codes showed better predictive performance. The reuse of student activity data is an easy and robust method for the development of QMs of caries risk that can help improve monitoring and quality of patient care.

Balkwill's angle, occlusal plane, mandibular shape, and curve of Spee.

OBJECTIVE: This study proposes a cephalometric method to determine an individual radius of the curve of Spee in cases of occlusal prosthetic rehabilitation. METHODS: A retrospective study was conducted on 469 lateral cephalograms. Statistical analysis was performed. Correlations were computed using simple regression, Z tests, paired t-tests, and one-way repeated measures ANOVA. RESULTS: Regression calculations supported a link between the radius of the curve of Spee and occlusal plane inclination, Balkwill's angle, mandibular parameters (MP), with MP = corpus - ramus + Bonwill height. Based on MP, data that are accessible even in the absence of teeth, a regression formula can be proposed to provide an individualized estimation of the radius of the Spee curve (RCS): RCS = 0.624 * MP + 26.583. CONCLUSION: This study proposes an individualized estimation of the RCS from only skeletal mandibular parameters: the length of the ramus, length of the corpus, and the Bonwill height.

Management of idiopathic sleep bruxism in children and adolescents: A systematic review of the literature.

AIM: Primary sleep bruxism (SB) affects between 6 and 30% of children and adolescents. Its frequency increases with age, reaching a peak at 10-14 years of age, after which it drops until adulthood. The treatment of SB has not been extensively documented, resulting in a lack of reference points and legitimate concerns for dentists in their everyday practice. The aim of this literature review was to summarize the available evidence on the management of SB in children and adolescents and the efficacy of the different approaches. METHOD: A systematic literature search was conducted according to PRISMA guidelines from January 2006 to December 2020 using the PubMed, The Cochrane Library, Science Direct, and Google Scholar databases. All types of SB treatment were accepted. Eight studies were selected for their protocol quality, according to the PICOS tool. RESULTS: Several treatment methods were assessed from the eight clinical studies selected, such as occlusal splint, palatal expansion, and pharmacological treatment. Assessment of the treatment methods was difficult because only eight studies were selected, and both the treatment methods and the study protocols used were different. The therapeutic strategies found in the literature were based on the general condition of the case. Treatment approaches were distinguished into treatments for isolated SB and those for SB associated with ventilatory disorders. CONCLUSION: The current study shows the need to define diagnostic criteria adapted to SB in children in order to improve epidemiological surveys and subsequently clinical practice. To overcome the difficulties related to SB diagnostic criteria, a multidisciplinary approach, involving pediatricians, otorhinolaryngologists, and dental practitioners, is essential for a better management and follow-up of young patients. A case-by-case approach, taking into account the specificities of each young patient, seems the most appropriate management today.

[What is a malocclusion?] / Qu'est-ce qu'une malocclusion ?

Since 1907, the international community has used Angle's classification to assess the mesio-distal relationships of the dental arches. It is the basis of the diagnosis of malocclusion in the sagittal dimension and indicates or not an orthodontic correction treatment. This work was aimed to inventory the classification methods of malocclusions used today. Indices of treatment need were also presented because they are based on one or more occlusal anomalies to indicate treatment. The classifications were criticized and the contribution of a functional analysis based on the use of the trilogy setting, centering and guiding was detailed. The type of anomalies (skeletal and dental) must be completed by the analysis of the occlusal anomaly of setting (centering or guiding) and of the category of occlusion (functional occlusion, functional malocclusion or pathogenic malocclusion), ie its possible pathogenic impact on orofacial structures. A consensus on the classification of occlusal anomalies is necessary in order to better identify the anomalies and their global repercussions, and to better define the needs for orthodontic treatment.