Osteíte condensante focal de grandes dimensões em paciente disfuncional cervicomastigatória com alteração vestibulococlear: relato de caso

Abstract

Condensing osteitis (CO) is a type of osteomyelitis characterized by areas of localized bone sclerosis at the apices of teeth with chronic pulpitis or necrotic pulps. It presents

radiographically as a radiopaque lesion, where there is a localized bone reaction from a low- grade inflammatory stimulus, usually located at the apex of a tooth or at the extraction site

where there has been long-standing pulp disease. Bruxism is a parafunction related to muscle hyperactivity, with a multifactorial etiology, and can be classified as a non-spontaneous act, leading to disordered jaw movements, generating clenching and/or grinding of the teeth, thus overloading the stomatognathic system. This report describes a 35-year-old Caucasian female patient complaining of severe headache. During the medical history, she mentioned being a bruxist. Clinical examination revealed left-sided mandibular interference, returning to the midline, and potential disc displacement with ipsilateral reduction. During protrusion, the disc deviated to the left. Regarding vestibulocochlear symptoms, she presented tinnitus in the right ear and ear fullness in both ears, as well as occasional vertigo. Physical examination revealed a clicking sound during opening movements in the right temporomandibular joint (TMJ). Sensitivity to palpation of muscle trigger points was observed, and marked tenderness was observed on the right side. Radiographic examination revealed large radiopaque areas located at the apices of teeth 36 and 46, where there were extensive amalgam restorations, which were endodontically treated after chronic pulpitis was found in both. The patient is undergoing treatment for cervicomastigatory dysfunction and related bruxism, which, in theory, was the aggravating factor for the bilateral OC in the mandibular molars.