Extensive focal condensing osteitis in a patient with cervicomasticatory dysfunction and vestibulocochlear changes

Abstract

Objective: To describe a clinical case of extensive focal condensing osteitis in a patient with cervicomasticatory dysfunction and vestibulocochlear alteration, highlighting the relationship between bruxism and the aggravation of the lesion. Case details: A 35-year-old female patient reported sensitivity in the lower right posterior teeth, associated with intense headache and diffuse pain, initially triggered by thermal stimuli. Clinical examination revealed mandibular movement restriction to the left side of 5 mm, as well as mandibular interference at 16 mm during mouth opening, followed by a return to the midline, characterizing mandibular deviation and suggesting possible ipsilateral disc displacement with reduction. The patient reported tinnitus in the right ear, bilateral aural fullness, and occasional episodes of vertigo. Muscle palpation revealed trigger points, indicating muscular overload consistent with ascending cervicomasticatory dysfunction. Panoramic radiography showed areas of bone condensation at the apices of teeth 36 and 46, which presented positive responses to pulp sensibility tests. The patient underwent treatment for cervicomasticatory dysfunction, as well as endodontic treatment of the involved teeth. Final considerations: The study highlights a possible association between thermal stimuli from extensive amalgam restorations and the exacerbated development of focal condensing osteitis, aggravated by parafunctional activity.