Bruxism assessment combining fractal analysis, clinical evaluation, and self-reports: a case-control study

Area of Science:

• Dentistry
• Radiology
• Biomedical Engineering

Background:

• Bruxism, characterized by teeth grinding and clenching, presents diagnostic challenges.
• Current diagnostic methods rely on clinical examination and patient-reported symptoms, lacking objective biomarkers.
• Investigating novel methods for bruxism assessment is crucial for improved diagnosis and management.

Purpose of the Study:

• To investigate the effects of bruxism using a combined approach.
• To evaluate fractal bone analysis as a potential objective measure for bruxism.
• To correlate fractal analysis findings with clinical and patient-reported outcomes.

Main Methods:

• Thirty-five bruxism patients and 35 controls underwent validated questionnaires, clinical examinations (tooth wear, muscle palpation, periodontal parameters), and radiographic analyses.
• Panoramic radiographs were used for structural evaluation.
• Fractal dimension analysis of mandibular first molars was performed using ImageJ software.

Main Results:

• Bruxism patients exhibited higher prevalence of females, lower education, and more systemic diseases.
• Significant clinical findings included increased tooth wear, soft tissue impressions, masseter hypertrophy, and muscle pain.
• Radiographic analysis revealed periodontal ligament widening, bone loss, and lamina dura changes, with fractal analysis showing increased dimension in interdental areas.

Conclusions:

• Bruxism is associated with distinct trabecular bone changes.
• Fractal analysis can detect these bone changes, offering a potential objective marker for bruxism.
• The findings support the integration of fractal analysis with clinical and self-reported data for comprehensive bruxism assessment.