Temporomandibular Disorders: “Occlusion” Matters!

Abstract

By analogy with the journal's title Pain Research and Management, this review describes TMD Research and Management. More specific are the (1) research aspects of “occlusion,” still one of the most controversial topics in TMD, and (2) as much as possible evidence-based management aspects of “TMD” for the dental practitioner. Research. The disorders temporomandibular dysfunction and the synonymous craniomandibular dysfunction are still being discussed intensely in the literature. Traditionally, attention is mostly devoted to occlusion and its relationship with these disorders. The conclusions reached are often contradictory. Considering the definitions of temporomandibular and craniomandibular dysfunctions/disorders and “occlusion,” a possible explanation for this controversy can be found in the subsequent methodological problems of the studies. Based on a Medline search of these terms over the past 40 years related to contemporary terms such as “Evidence Based Dentistry” and “Pyramid of Evidence,” these methodological aspects are examined, resulting in recommendations for future research and TMD-occlusal therapy. Management. To assist the dental practitioner in his/her daily routine to meet the modern standards of best practice, 7 guidelines are formulated that are explained and accompanied with clinical examples for an evidence-based treatment of patients with this disorder in general dental practices.

<p>Temporomandibular disorders: improving outcomes using a multidisciplinary approach</p>

“…The stomatognathic system has a great ability to adapt to changes, including occlusal changes. From the constant eruption/dental change, the dental losses and their rehabilitations, the system adapts 75,97…”

Mechanism of Multi-loop Edgewise Archwire technique in correcting Class II anterior open bites with temporomandibular disorders – a retrospective cephalometric study in Chinese patients&nbsp;

“…It is necessary to conduct X-ray screening for patients with TMD symptoms before initiating orthodontic treatment. This will help the orthodontist determine whether the patient is in the quiescent or progressive stage, so as to avoid problems in the subsequent orthodontic treatment [20,21]. At present, most experts recommend conservative treatment for mild to moderate TMD patients to stabilize the TMD.…”

Conhecimento de cirurgiões-dentistas sobre a relação entre disfunção temporomandibular e fatores oclusais

“…Fundamentado nisso, várias revisões sistemáticas buscaram resposta sobre a associação entre má oclusão e DTM. Essas revisões chegaram a uma conclusão em comum: há ausência de evidência de que o ajuste oclusal trata ou previne a DTM 16,19,20 . Contudo, é importante ter em mente que existe diferença entre ausência de evidência e evidência de ausência.…”