A literature review on the causal relationship between Occlusal Factors (OF) and Temporomandibular Disorders (TMD) IV: experimental studies on occlusal adjustment by occlusal carving as a preventive or therapeutic intervention


  • Rodolfo Acosta-Ortiz Nova Southeastern University
  • Nelson Roura-Lugo Universidad de Puerto Rico, USA


Occlusion, Temporomandibular disorders, Etiology, Occlusal factors, Temporomandibular joint, Experimental studies, Occlusal adjustment, Selective tooth grinding


Introduction: this is the fourth article in a series that have as purpose to present a literature review about the causal relationship between the occlusal factors (OF) and temporomandibular disorders (TMD). Methods: this article presented and analyzed experimental studies in which researchers used occlusal adjustment (OA) as a therapeutic means for TMDs and other associated disorders. Results and conclusions: the analysis of the studies presented in this literature review shows that the actual evidence does not support the use of OA as a primary therapeutic method. This is especially true when one considers the fact that it is an irreversible treatment, with secondary effects (tooth sensitivity) and that is limited to certain occlusal schemes.

= 201 veces | PDF
= 87 veces| | PDF (ESPAÑOL (ESPAÑA))
= 93 veces|


Download data is not yet available.

Author Biographies

Rodolfo Acosta-Ortiz, Nova Southeastern University

Profesor Adjunto. Departamento de Prostodoncia. Colegio de Medicina Dental. Nova Southeastern University.

Nelson Roura-Lugo, Universidad de Puerto Rico, USA

Dr. Nelson Roura Lugo. DMD, MS Odontólogo de la Universidad de Puerto Rico. Certificado en Prostodoncia y Maestría en Ciencias Restaurativas de la Universidad de Michigan, USA. Catedrático Asociado. Decanato Auxiliar de investigación y Programa Graduado de Prostodoncia. Escuela de Medicina Dental, Universidad de Puerto Rico, USA.



Acosta Ortiz R, Rojas BP. Una revisión de la literatura sobre la relación causal entre los factores oclusales (FO) y los desórdenes temporomandibulares (DTM) I: estudios epidemiológicos descriptivos. Rev Fac Odontol Univ Antio.q 2006; 17(2): 67-85.

Acosta Ortiz R, Rojas BP. Una revisión de la literatura sobre la relación causal entre los factores oclusales (FO) y los desórdenes temporomandibulares (DTM) II: estudios epidemiológicos analíticos de observación. Rev Fac Odontol Univ Antioq. 2006; 18(1): 55-67.

Acosta R, Roura N. Una revisión de la literatura sobre la relación causal entre los factores oclusales (FO) y los desórdenes temporomandibulares (DTM) III: estudios experimentales con interferencias oclusales (IO) artificiales. Rev Fac Odontol Univ Antioq. 2008; 20(1): 87-96.

Mohl ND. Standards for testing new diagnostic strategies for temporomandibular disorders. En: Fricton JR, Dubner RB (eds). Orofacial Pain and Temporomandibular Disorders: advances in pain research and therapy. New York: Raven Press; 1994.

Ingervall B, Carlsson GE. Masticatory muscle activity before and after elimination of balancing side occlusal interferences. J Oral Rehabil. 1982; 9(3): 183-92. DOI: https://doi.org/10.1111/j.1365-2842.1982.tb01008.x

Ettola-Ylitalo UM. Effects of occlusal adjustment on the periodontal condition and on symptoms of masticatory dysfunction in patients treated with fixed prosthesis – A one year follow-up study. J Oral Rehabil. 1986; 13(6): 509-19. DOI: https://doi.org/10.1111/j.1365-2842.1986.tb00674.x

Kirveskari P, Alanen P, Jämsä T. Association between cranio- mandibular disorders and occlusal interferences. J Prosthet Dent. 1989; 62(1): 66-9. DOI: https://doi.org/10.1016/0022-3913(89)90052-8

Kirveskari P, Le Bell Y, Salonen M, Forssell H, Grans L. The effect of the elimination of occlusal interferences on signs and symptoms of craniomandibular disorders in young adults. J Oral Rehabil. 1989; 16(1): 21-6. DOI: https://doi.org/10.1111/j.1365-2842.1989.tb01313.x

Kirveskari P, Alanen P, Jämsä T. Association between craniomandibular disorders and occlusal interferences in children. J Prosthet Dent. 1992; 67(5): 692-6. DOI: https://doi.org/10.1016/0022-3913(92)90173-8

Kirveskari P, Alanen, P. Odds ratio in the estimation of the significance of occlusal factors in craniomandibular disorders. J Oral Rehabil. 1995; 22(8): 581-4. DOI: https://doi.org/10.1111/j.1365-2842.1995.tb01052.x

Karjalainen M, Le Bell Y, Jämsä T, Kayalainen S. Prevention of temporomandibular disorder related signs and symptoms in orthodontically treated adolescents: a 3-year follow-up of a prospective randomized trial. Acta Odontol Scand. 1997; 55(5): 319-24. DOI: https://doi.org/10.3109/00016359709114971

Kirveskari P, Jämsä T, Alanen P. Occlusal adjustment, and the incidence of demand for temporomandibular disorder treatment. J Prosthet Dent. 1998; 79(4): 433-8. DOI: https://doi.org/10.1016/s0022-3913(98)70158-1

Ramfjord SP. Dysfunctional temporomandibular joint and muscle pain. J Prosthet Dent. 1961; 1(2): 353-74. DOI: https://doi.org/10.1016/0022-3913(61)90212-8

Goodman P, Greene CS, Laskin DM. Response of patients with myofascial pain dysfunction syndrome to mock equilibration. J Am Dent Assoc. 1976; 92(4): 755-8. DOI: https://doi.org/10.14219/jada.archive.1976.0419

Kopp S. Short-term evaluation of counseling and occlusal adjustment in patients with mandibular dysfunction involving the temporomandibular joint. J Oral Rehabil. 1979; 6(2): 101-9. DOI: https://doi.org/10.1111/j.1365-2842.1979.tb01270.x

Koop S, Wenneberg B. Effect of occlusal treatment and intraarticular injections on temporomandibular joint pain and dysfunction. Acta Odontol Scand. 1981; 39(2): 87-96. DOI: https://doi.org/10.3109/00016358109162265

Sheikholesman A, Möller E, Lous I. Postural and maximal activity in elevators of mandible before and after treatment of functional disorders. Scand J Dent Res. 1982; 90(1): 37-46. DOI: https://doi.org/10.1111/j.1600-0722.1982.tb01522.x

Tsolka P, Morris RW, Preiskel HW. Occlusal adjustment therapy for craniomandibular disorders: a clinical assessment by a double blind method. J Prosthet Dent. 1992; 68(6): 957-64. DOI: https://doi.org/10.1016/0022-3913(92)90558-r

Tsolka P, Preiskel HW. Kiniseographic and electromyographic assessment of the effects of occlusal adjustment therapy on craniomandibular disorders by a double blind method. J Prosthet Dent. 1993; 69(1): 85-92. DOI: https://doi.org/10.1016/0022-3913(93)90246-k

Kerstein RB, Chapman R, Klein MA. A comparison of ICAGD (immediate complete anterior guidance development) to mock ICAGD for symptom reductions in chronic myofascial pain dysfunction patients. Cranio. 1997; 15(1): 21-37. DOI: https://doi.org/10.1080/08869634.1997.11745990

Forssell H, Kirveskari P, Kangasniemi P. Changes in headache after treatment of mandibular dysfunction. Cephalalgia 1985; 5(4): 229-36. DOI: https://doi.org/10.1046/j.1468-2982.1985.0504229.x

Forssell H, Kirveskari P, Kangasniemi P. Effect of occlusal adjustment on mandibular dysfunction: a double blind study. Acta Odontol Scand. 1986; 44(2): 63-9. DOI: https://doi.org/10.3109/00016358609041309

Forssell H, Kirveskari P, Kangasniemi P. Response to occlusal treatment in headache patients previously treated by mock occlusal adjustment. Acta Odontol Scand. 1987; 45(2): 77-80. DOI: https://doi.org/10.3109/00016358709098360

Wenneberg B, Nystrom T, Carlsson GE. Occlusal equilibration and other stomatognathic treatment in patients with mandibular dysfunction and headache. J Prosthet Dent. 1988; 59(4): 478-82. DOI: https://doi.org/10.1016/0022-3913(88)90046-7

Vallon D, Ekberg EC, Nilner M, Kopp S. Short-term effect of occlusal adjustment on craniomandibular disorders including headaches. Acta Odontol Scand. 1991; 49(2): 89-96. DOI: https://doi.org/10.3109/00016359109005892

Vallon D, Ekberg EC, Nilner M, Kopp S. Occlusal adjustment in patients with craniomandibular disorders including headaches: a 3- and 6-months follow-up. Acta Odontol Scand. 1995; 53(1): 55-9. DOI: https://doi.org/10.3109/00016359509005946

Vallon D, Nilner M. A longitudinal follow-up of the effect of occlusal adjustment in patients with craniomandibular disorders. Swed Dent J. 1997; 21(3): 85-91.

Ramfjord SP. Bruxism, a clinical and electromyographic study. J Am Dent Assoc. 1961; 1: 21-44. DOI: https://doi.org/10.14219/jada.archive.1961.0002

Kardachi BJ, Bailey JO, Ash MM. A comparison of biofeedback and occlusal adjustment on bruxism. J Periodontol. 1978; 49(7): 367-72. DOI: https://doi.org/10.1902/jop.1978.49.7.367

Bailey JO, Rugh JD. Effect of occlusal adjustment on bruxism as monitored by nocturnal EMG recordings. J Dent Res. 1981; 46(3): 241. DOI: https://doi.org/10.1016/0022-3913(81)90207-9

Puhakka HJ, Kirveskari P. Globus hystericus: Globus syndrome? J Laryngol Otol. 1988; 102(3): 231-4. DOI: https://doi.org/10.1017/S0022215100104608

Karppinen K, Eklund S, Souninen E, Eskelin M, Kirveskari P. Adjustment of dental occlusion in treatment of chronic cervicobrachial pain and headache. J Oral Rehabil. 1999; 26(9): 715-21. DOI: https://doi.org/10.1046/j.1365-2842.1999.00448.x

Ad hoc Committee On Classification Of Headache. Classification on headache. Arch Neurol. 1962; 6(3): 717-8. DOI: https://www.doi.org/10.1001/archneur.1962.00450210001001

Helkimo M. Studies on function and dysfunction of the masticatory system. Index for anamnestic and clinical dysfunction and occlusal state. Sven Tandlak Tidskr. 1974; 67(2):101-21.

Riise C. Rational performance of occlusal adjustment. J Prosthetic Dent. 1982; 48(3): 319-27. DOI: https://doi.org/10.1016/0022-3913(82)90020-8

Dawson PE. Evaluation, diagnosis and treatment of occlusal problems. 2.ª ed. St Louis: CV Mosby; 1989.

Kogh Poulsen WG. Management of the occlusion of the teeth: examination, diagnosis, treatment. En: Schwartz L, Chayanes CM (eds). Facial pain and mandibular dysfunction. W.B Saunders Co. Philadelphia; 1969. p. 25-258.

Ramfjord S, Ahs MM. Occlusion. 3.ª ed. Philadelphia: WB Saunders Company;1983. p. 384-424.

Kerstein RB. A comparison of traditional occlusal equilibration and immediate complete anterior guidance development. Cranio. 1993; 11(2): 126-40. DOI: https://doi.org/10.1080/08869634.1993.11677954

De Boever JA, Carlsson GE, Klineberg IJ. Need for occlusal therapy and prosthodontic treatment in the management of temporomandibular disorders. Part I. Occlusal interferences and occlusal adjustment. J Oral Rehabil. 2000; 27(5): 367-79. DOI: https://doi.org/10.1046/j.1365-2842.2000.00574.x

Tsukiyama Y, Baba K, Clark GT. An evidence-based assessment of occlusal adjustment as a treatment for temporomandibular disorders. J Prosthet Dent. 2001; 86(1): 57-66. DOI: https://doi.org/10.1067/mpr.2001.115399

Fricton J. Current evidence providing clarity in management of temporomandibular disorders: summary of a systematic review of randomized clinical trials for intra-oral appliances and occlusal therapies. J Evid Base Dent Pract. 2006; 6(1): 48-52. DOI: https://doi.org/10.1016/j.jebdp.2005.12.020

Koh H, Robinson PG. Occlusal adjustment for treating and preventing temporomandibular joint disorders. J Oral Rehabil. 2004; 31(4): 287-92. DOI: https://doi.org/10.1046/j.1365-2842.2003.01257.x

Forssell H, Kalso E. Application of principles of evidence- based medicine to occlusal treatment for temporomandibular disorders: are there lessons to be learned? J Orofacial Pain. 2004; 18(1): 9-22.

Forssell H, Kalso E, Koskela P, Vehmanen R, Puukka P, Alanen P. Occlusal treatments in temporomandibular disorders: a qualitative systematic review of randomized controlled trials. Pain. 1999; 83(3): 549-60. DOI: https://doi.org/10.1016/s0304-3959(99)00160-8

Huang GJ. Occlusal adjustment for treating and preventing temporomandibular disorders. Am J Orthod Dentofacial Orthop. 2004; 126(2): 138-9. DOI: https://doi.org/10.1016/j.ajodo.2004.06.013

Kirveskari P. The role of occlusal adjustment in the management of temporomandibular disorders. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997; 83(1): 87-90. DOI: https://doi.org/10.1016/s1079-2104(97)90097-4

Smukler H. Equilibration in the natural and restored dentition: a rational basis for and technique of occlusal equilibration. Chicago: Quintessence Publishing; 1991.

Okeson J. Orofacial pain: guidelines for assessment, diagnosis and management. Chicago: Quintessence; 1996.



How to Cite

Acosta-Ortiz, R., & Roura-Lugo, N. (2009). A literature review on the causal relationship between Occlusal Factors (OF) and Temporomandibular Disorders (TMD) IV: experimental studies on occlusal adjustment by occlusal carving as a preventive or therapeutic intervention. Revista Facultad De Odontología Universidad De Antioquia, 21(1), 98–111. Retrieved from https://revistas.udea.edu.co/index.php/odont/article/view/2182

Most read articles by the same author(s)

Similar Articles

1 2 3 4 5 6 7 > >> 

You may also start an advanced similarity search for this article.