A review of the literature on the causal relationship between occlusal factors (OFs) AND temporomandibular disorders (TMDs). VI: final conclusions
Keywords:Occlusion, Temporomandibular disorders, Etiology, Dental occlusion, Occlusal factors, Temporomandibular joint, Occlusal adjustmnet, Orthodontic treatment, Causality
Introduction: this is the sixth and last article of this extensive and complete literature review which purpose was to evaluate the possible causal relationship between occlusal factors (OFs) and temporomandibular disorders (TMDs). Methods: of all the articles found, only the analytical epidemiologic studies were included, and they were analyzed by means of the epidemiologic criteria commonly used to establish causality (cause/effect). Results: the findings suggest that, although the first criterion —strength of the associations between OFs and TMDs— existed, other criteria such as consistency with other studies, temporal sequence of events, dose-response relation and biologic credibility cannot be supported with the current available scientific information. Therefore, if there is a causal relationship, it is a weak one. Conclusion: with the scientific information available today, evidence of a causal relationship between OFs and TMDs is weak and confusing. More and better studies are needed, with improvement of research methods. This will pave the way for clearer and more concrete results that will also help to make more solid interpretations and conclusions about the possible causal relationship between OFs and TMDs.
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