MIRROR PATHOLOGIES: PERIAPICAL LESIONS INDUCED BY OCCLUSAL TRAUMA IN IDENTICAL TWINS – A CASE REPORT

Background:Trauma from occlusion is a significant etiological factor in dental conditions requiring endodontic
intervention. As originally defined by Stillman in 1917, trauma from occlusion refers to damage to the supporting
structures of the teeth resulting from occlusal forces generated during jaw closure. The periodontium attempts to adapt to these forces; however, this adaptive capacity varies among individuals. When the occlusal load exceeds the
periodontium threshold, tissue injury ensues.
Key factors influencing the traumatic impact include the magnitude, direction, and duration of occlusal forces.
Increased force magnitude leads to periodontal ligament (PDL) space widening, an increase in PDL fiber density, and
changes in alveolar bone density. Continuous forces tend to cause more severe damage than intermittent ones, though
the frequency of intermittent force application can also elevate injury risk.
This case report presents a rareoccurrence of monozygotic twin sisters, aged 9 years, exhibiting periapical pathological lesions in the mandibular anterior region, attributed to trauma from occlusion. The presence ofsimilar occlusal patterns and lesion localization in identical twins is an uncommon finding. Clinical and radiographic evaluations revealed nonvital teeth and well-defined periapical radiolucencies in thesameregion for twins, despite theabsence of carious lesions.
These findings suggest that occlusal factors, possibly influenced by hereditary traits, played a significant role in the
etiology of the lesions. This case underscores the potential genetic basis of occlusal morphology and its implications
in the development of traumatic occlusal lesions in pediatric patients