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Prevalence of missing posterior teeth and intraarticular temporomandibular disorders
Ross H Tallents1, Donald J Macher, Stephanos Kyrkanides
1Department of Dentistry, Division of Orthodonics and Prosthodonics, Eastman Dental Center, University of Rochester, Rochester, NY, USA. rosst@frontiernet.net
Statement Of Problem:
The association between missing mandibular posterior teeth and the development of intraarticular temporomandibular disorders (TMDs) remains unclear.
Purpose:
The purpose of this study was to evaluate the prevalence of missing mandibular posterior teeth and intraarticular TMDs in a mixed population of asymptomatic subjects and symptomatic TMD patients.
Material And Methods:
Eighty-two asymptomatic volunteers and 263 symptomatic TMD patients were included in this study. Asymptomatic volunteers completed a subjective questionnaire and underwent clinical examination to document the absence of TMD signs and symptoms. All symptomatic subjects had localized jaw joint pain and pain on movement or when eating. The number of missing mandibular bicuspid and molar teeth (excluding third molars) in each subject was recorded, and magnetic resonance images were made to document the presence or absence of disk displacement in the temporomandibular joints. Subjects were divided into 4 groups: group 1 = asymptomatic, normal magnetic resonance imaging result; group 2 = asymptomatic, disk displacement; group 3 = symptomatic, normal magnetic resonance imaging result; and group 4 = symptomatic, disk displacement. Collected data were analyzed with chi-square tests (P<.05) with no adjustment for multiple comparisons.
Results:
A positive association between missing mandibular posterior teeth and the presence of disk displacement was found.
Conclusion:
The literature does not suggest that replacement of missing posterior teeth prevents the development of TMDs. However, missing mandibular posterior teeth may accelerate the development of degenerative joint disease.