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Apical periodontitis after intense bruxism.

Madline P Gund1, Karl-Thomas Wrbas2,3, Matthias Hannig4

  • 1Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University Hospital, Saarland University, Kirrberger Str. 100, Building 73, 66421, Homburg, Saar, Germany. madline.gund@uks.eu.

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Summary

Bruxism, or teeth grinding, can lead to apical periodontitis, an infection at the root tip. This case highlights the importance of considering bruxism in diagnosing unexplained tooth pain.

Keywords:
Apical periodontitisBruxismCase-reportCracked tooth syndromeOcclusal traumaPerio-endo lesion

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Area of Science:

  • Dentistry
  • Endodontics
  • Oral Medicine

Background:

  • Bruxism commonly causes masticatory muscle pain, TMJ issues, headaches, tooth wear, and dental complications.
  • The link between bruxism and pulpal damage is primarily experimental, with limited clinical documentation.
  • This study introduces the first reported clinical case of apical periodontitis directly linked to bruxism.

Observation:

  • A 28-year-old male presented with apical periodontitis affecting teeth 36 and 46.
  • The patient experienced an intense period of bruxism prior to symptom onset.
  • Diagnosis was delayed due to the unclear etiology of the severe tooth pain.

Findings:

  • Successful root canal treatment was performed on the affected teeth.
  • The case demonstrates a direct clinical correlation between intense bruxism and the development of apical periodontitis.
  • This finding expands the known pathological consequences of bruxism.

Implications:

  • Clinicians must recognize that severe bruxism can cause apical periodontitis.
  • Thorough patient history (anamnesis) is crucial for diagnosing unexplained dental pain.
  • Considering bruxism in differential diagnosis can prevent delayed treatment and improve patient outcomes.