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TMD and occlusion part I. Damned if we do? Occlusion: the interface of dentistry and orthodontics
1Department of Orthodontics, Child Dental Health, Leeds Dental Institute, Clarendon Way, Leeds, UK. f.luther@leeds.ac.uk
Objectives:
To review how occlusion, facial growth, TM disc position and malocclusion may relate to TMD; to review clinical studies investigating TMD pre- and post-orthodontic treatment as well as other studies linking occlusal features with TMD highlighting their limitations; and to make suggestions for improved study designs in the future in order to provide an evidence-base for clinical practice.
Design:
Review article.
Methods:
Electronic databases (MEDLINE and the Cochrane Database of Systematic Reviews) were used to select relevant and frequently cited studies (mean: 28 citations). Citation rate was confirmed using the Web of Science. Study designs are reviewed and weaknesses discussed.
Results:
Evidence is lacking to suggest static occlusal factors cause TMD.
Conclusions:
Poor study designs have led to much of the controversy over whether occlusal factors (including orthodontics) 'cause' TMD. In order to provide an evidence-base for future clinical practice, suggestions to improve study designs are made.
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