Occlusal imbalance and temporomandibular disorders in the elderly

The prevalence of the anamnestic symptoms and clinical signs of temporomandibular disorders (TMD) in 76-, 81-, and 86-year-old subjects was studied, on the basis of Helkimo's anamnestic (Ai) and clinical (Di) dysfunction indexes. Occlusal status was recorded by means of the Eichner index: class A has a maximum of four supporting zones (minimum of one tooth contact between the antagonist jaws in the premolar and molar region on each side), class B has one to three supporting zones or tooth contact in the frontal area only, and class C has no supporting zones. The Eichner index was recorded with two kinds of variations: supporting zones with and without removable prostheses. In the population studied 8% were classified as Eichner class A, 22% as class B, and 70% as class C. Including occlusal supporting zones of the removable dentures, the percentages were 75% in Eichner class A, 21% in class B and 4% in class C. When the groups with and without removable prostheses were compared, no differences were found in the Ai or Di. In conclusion, among the elderly population the severity of TMD does not depend on the supporting zones of the dentition alone, and removable prostheses do not relieve the problem.