Dental occlusion and temporomandibular disorders

Area of Science:

• Dentistry
• Oral and Maxillofacial Surgery
• Rheumatology

Background:

• Temporomandibular disorders (TMD) are complex conditions affecting the jaw joint and muscles.
• The role of dental occlusion in the pathophysiology of TMD has been a long-standing debate in dentistry.
• Previous research has yielded inconsistent findings regarding the association between occlusal factors and TMD.

Purpose of the Study:

• To systematically evaluate the existing clinical evidence on the association between features of dental occlusion and temporomandibular disorders (TMD).
• To determine if specific occlusal characteristics are clinically relevant in the development or manifestation of TMD.
• To inform clinical practice and guide future research directions regarding TMD etiology.

Main Methods:

• A comprehensive literature search was conducted across Medline, Scopus, and Google Scholar databases.
• Two independent reviewers selected English-language clinical studies assessing the TMD-occlusion relationship.
• Study quality was evaluated using the Newcastle-Ottawa Scale (NOS), followed by a narrative synthesis of findings.

Main Results:

• Twenty-five studies (17 case-control, 8 comparative) met the inclusion criteria.
• A high variability was observed in the association between occlusal features and TMD diagnosis across studies.
• No consistent, clinically relevant association was found between most occlusal features and TMD; only mediotrusive interferences showed a consistent link in multiple variable analyses.

Conclusions:

• The findings suggest the absence of a disease-specific association between dental occlusion and TMD.
• There is insufficient evidence to support a major role for dental occlusion in the pathophysiology of TMD.
• Dental clinicians should reconsider the traditional gnathological paradigm and focus on other etiological factors for TMD.