Occlusal changes secondary to temporomandibular joint conditions: a critical review and implications for clinical practice

Abstract

The relationship between Temporomandibular Disorders (TMD) and malocclusion is an extremely critical issue in dentistry. Contrary to the old concept that malocclusion causes TMD, occlusal changes, especially those observed as sudden, may be secondary and reflect joint or muscle disorders due to the obvious connection between these structures and the dental occlusion. ObjectivesThe aim of this article is to present the most commonly occlusal changes secondary to TMD.MethodsThe clinical presentation of these conditions is discussed. Details regarding diagnosis, treatment, and follow-up of patients presenting TMD prior or during treatment are also presented.ConclusionsAll plans for irreversible therapy should be preceded by a meticulous analysis of TMD signs and symptoms in such a way that patients are not submitted to irreversible treatment, based on an untrue occlusal relationship, secondary to articular and/or muscular disorders. When present, TMD symptoms must always be controlled to reestablish a “normal” occlusion and allow proper treatment strategy.

Association of malocclusion, self-reported bruxism and chewing-side preference with oral health-related quality of life in patients with temporomandibular joint osteoarthritis

“…In the present study, malocclusion was not significantly associated with either the total score or any domain score of the OHIP‐C14. Based on previous literature, involving both human research and animal research, TMJ‐OA tended to be associated with malocclusion and the association was bidirectional. However, there was no literature focusing on the relationship between malocclusion and OHRQoL in patients with TMJ‐OA.…”

“…Besides, on one hand, if the malocclusion was present before TMJ‐OA occurred, it means that the malocclusion was more likely to have been present for a long time and patients may already be used to the malocclusion in daily life and are not likely to report feel discomfort in eating in the preceding 1 month. On the other hand, if the malocclusion of the patients occurred secondary to TMJ‐OA, patients may have anterior open bite, which is called acquired open bite associated with TMJ‐OA. However, acquired open bite associated with TMJ‐OA is not very common and TMJ‐OA can only cause relatively minor open bite changes with slow progression.…”

“…On the other hand, if the malocclusion of the patients occurred secondary to TMJ‐OA, patients may have anterior open bite, which is called acquired open bite associated with TMJ‐OA. However, acquired open bite associated with TMJ‐OA is not very common and TMJ‐OA can only cause relatively minor open bite changes with slow progression. Therefore, anterior open bite is not likely to make patients uncomfortable eating.…”

“…Besides, on one hand, if the malocclusion was present before TMJ-OA occurred, it means that the malocclusion was more likely to have been present for a long time and patients may already be used to the malocclusion in daily life and are not likely to report feel discomfort in eating in the preceding 1 month. 7 . Therefore, anterior open bite is not likely to make patients uncomfortable eating.…”

Occlusal stability and mandibular stability: The major part of dentistry we are still neglecting

“…That is because stability is a term used in dentistry to imply temporality: the capacity of an occlusion, dental prosthetics, or dentures to remain constant in character or position in osteoarthritic changes, may be secondary to the degenerative joint disease [16]. Additionally, intra-articular inflammatory process in the temporomandibular joint (TMJ) can provoke acute malocclusions [17]. Consequently, it seems reasonable to argue that a stable occlusion depends on an equilibrium of the masticatory system, in which the TMJ and musculature should be healthy or at least adapted in a non-ideal but still physiologic position.…”