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.