Radiographic Evaluation of Bruxism-Related Mandibular Bone Adaptation in Periodontitis and Non-Periodontitis

Abstract

Background: Bruxism (BR) defined as repetitive jaw muscle activity, is a parafunctional condition linked to occlusal trauma and bone remodeling. Although the effects on the periodontium are debated, the connection between mechanical stress from BR and mandibular bone adaptation, especially in those with periodontitis, has not been thoroughly examined. This study aimed to evaluate the grade and symmetry of mandibular bone apposition in individuals with probable BR comparing those with periodontitis and non-periodontitis.

Methods: A total of 110 adults diagnosed with BR were recruited for the study. Participants were divided into 2 groups based on their periodontal status: those with periodontitis and non-periodontitis. Panoramic radiographs assessed bone apposition in the gonial region, graded on a scale from 0 to 3. Clinical periodontal parameters, including probing depth, clinical attachment loss, and bleeding on probing, were recorded alongside demographic data. Group comparisons were conducted using ANOVA and chi-square tests, with additional regression and symmetry analyses (Bowker’s test and Cohen’s Kappa) applied to evaluate side-specific apposition patterns.

Results: Participants diagnosed with periodontitis tended to be older and exhibited more severe clinical parameters and tooth loss compared to those without periodontitis (P < .0001). The periodontitis group had a higher occurrence of advanced bone apposition grades (G2 and G3), especially on the left side of the mandible. A significant asymmetry was observed between bone apposition grades G0 and G1 in side-to-side comparisons (P = .0078), suggesting unilateral early-stage bone remodeling in certain individuals. Conversely, advanced apposition grades were generally bilateral and linked to periodontitis.

Conclusion: The results suggest that periodontitis may impact both the extent and distribution pattern of mandibular bone apposition in individuals with BR. Radiographic identification of bone apposition, especially regarding periodontal degradation, could provide further diagnostic benefits for evaluating occlusal overload and mandibular bone adaptation.

Cite this article as: Soysal F, Eberlik.se H, Güney Z. Radiographic evaluation of bruxism-related mandibular bone adaptation in periodontitis and non-periodontitis. Essent Dent. 2026, 5, 0079, doi:10.5152/EssentDent.2026.25079.