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DDS, MSc, PhD, Dip FMS, FHId, Specialist in Endodontics, Assistant Professor in Endodontology, Faculty of Dentistry, Aristotle University of Thessaloniki, Greece
Bruxism is a repetitive masticatory muscular activity characterized by the grinding and clenching of teeth and/or thrusting of the mandible. This activity can occur during the day (awake bruxism) or at night (sleep bruxism) and patients can potentially generate mandibular forces of up to 900N. This has been known to crack or break unrestored teeth, indirect restorations and even implant fixtures. This article provides an overview of the endodontic considerations in those who experience bruxism and who have cracked teeth.
CPD/Clinical Relevance: Bruxism can affect tooth structural integrity and pulp vitality, and can compromise tooth survival.
Article
Bruxism is the repetitive masticatory muscular activity characterized by the grinding and clenching of teeth and or thrusting of the mandible.
This activity can occur during the day (awake bruxism) or at night (sleep bruxism) and patients can potentially generate mandibular forces up to 91.7kg (900N), while normal human chewing forces range from 36.4kg (352.3N) for women to 45.7kg (441.5N) in men.1 Patients who have a bruxist habit have been known to generate enough force to crack or break unrestored teeth, indirect restorations and even implant fixtures.1
The teeth most commonly affected by cracking/fracturing owing to excessive occlusal loading are mandibular second molars, mandibular first molars and maxillary premolars, with the least affected being mandibular premolars.2
The International Consensus on Assessment of Bruxism states that bruxism should be considered a risk factor for negative oral health consequences as opposed to a disorder in otherwise healthy individuals.3
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