Oral Clinical and Radiological Signs of Excessive Occlusal Forces in Bruxism.

Background/Objectives: Excessive occlusal forces manifest in bruxism and have consequences on teeth and jaws. The aim of this study was to determine the association of bruxism with clinical and radiological signs of excessive occlusal forces, such as tooth wear, fatigue dental fissures and fractures, abfraction, masseter muscle hypertrophy, and bone apposition at the mandibular angle. Methods: This cross-sectional clinical study included 181 patients presented for treatment in a general dentistry clinic. For each patient, data were extracted from the dental chart, as follows: demographic data (sex, age, and smoking), clinical data (number of teeth present, Eichner edentulous score, TWI wear score, number of fractured teeth, number of teeth with abfraction, presence of masseter hypertrophy, presence of hypersensitivity), and radiological data (bone apposition at the mandibular angle). The patients were divided into two groups according to the presence or absence of bruxism. A binomial logistic regression model was run to determine the association between bruxism and clinical and radiological signs of excessive occlusal forces. The data were statistically processed in SPSS. Results: In total, 99 women and 82 men with mean age 44.87 ± 12.67 were included in the study. Compared to the group without bruxism, the group of patients with bruxism (39.78%) showed statistically significant higher tooth wear index (TWI) (p < 0.0005), a higher number of fractured teeth (p = 0.037), a higher number of teeth with abfraction lesions (p = 0.001), and a significantly higher bone apposition score (p < 0.0005). The binomial logistic regression model showed a high prediction bruxism score for masseter muscle hypertrophy (15 times, p < 0.0005), for tooth wear index (almost 7 times, p = 0.010), and for bone apposition score (almost 3 times, p = 0.044). Conclusions: Patients with bruxism showed masseter muscle hypertrophy, higher attrition-type tooth wear index, and more teeth with fatigue fractures and abfractions than those without bruxism. Bruxism clinical signs were positively correlated with a higher bone apposition score.