Relationship between malocclusion and craniomandibular dysfunction in children and adolescents: a review

Review of the literature on the relationship between malocclusion and craniomandibular dysfunction is presented. The results were interpreted by applying the epidemiologic approach of "necessary and sufficient," which implies that there must be a one-to-one relationship between a factor and a disease. If the correlation between malocclusion and craniomandibular dysfunction were a one-to-one relationship, one would expect to see significant correlations reported consistently. Some of the studies found such significant correlations, however most of the correlations were weak. The lack of consistency and strength of the reported correlations does not support causality. On the basis of the evidence provided by the reviewed studies, malocclusion cannot be considered a necessary and/or sufficient etiologic factor of craniomandibular dysfunction. Therefore, early treatment of occlusal conditions to prevent the development of craniomandibular dysfunction is not justified scientifically.