A literature review on the causal relationship between Occlusal Factors (OF) and Temporomandibular Disorders (TMD) VI: final conclusions
Keywords:
Occlusion, Temporomandibular disorders, Etiology, Dental occlusion, Occlusal factors, Temporomandibular joint, Occlusal adjustmnet, Orthodontic treatment, CausalityAbstract
Introduction: this is the sixth and last article of this extensive and complete literature review whose purpose was to evaluate the possible causal relationship between occlusal factors (OFs) and temporomandibular disorders (TMDs). Methods: the analysis included only the analytical epidemiologic studies —out of all the articles found —, and they were analyzed using 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 relationship and biologic plausibility cannot be supported with the currently available scientific information. Therefore, if there is a causal relationship, it is a weak one. Conclusion: the scientific information available today provides weak and confusing evidence regarding the causal relationship between OFs and TMDs. More and better studies are needed, with improved research method that allow controlling confounding variables. 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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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 Antioq. 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-Ortiz 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.
Acosta R, Roura N. Una revisión de la literatura sobre la relación causal entre los factores oclusales (FO) y los desórdenes temporomandibulares (DTM) IV: estudios experimentales del ajuste oclusal por tallado selectivo como intervención preventiva o terapéutica. Rev Fac Odontol Univ Antioq. 21: 98-111.
Acosta R, Rojas BP. Una revisión de la literatura sobre la relación causal entre los factores oclusales (FO) y los desórdenes temporomandibulares (DTM) V: efecto de los cambios en los factores oclusales conseguidos con el tratamiento de ortodoncia. Rev Fac Odontol Univ Antioq. 2011; 22(2): 205-26.
Hennekens CH, Buring JE. Epidemiology in medicine. Boston: Mayrent SL: Philadelphia; 1987.
Rothman KJ, Greenland S, Lash TL. Modern epidemiology. 3.ª ed. Philadelphia: Lippincott Williams & Wilkins; 2008.
Lilienfeld DE, Stolley PD, Lilienfeld AM. Foundations of epidemiology. 3.ª ed. New York: Oxford University Press; 1994.
Geering AH. Occlusal interferences and functional disturbances of the masticatory system. J Clin Periodontol. 1974; 1(2): 112-9. DOI: https://doi.org/10.1111/j.1600-051x.1974.tb01246.x
Pullinger AG, Xu Y, Solberg WK. Relationship of occlusal stability to masticatory disorders. J Dent Res. 1984; 55: 498.
Seligman DA, Pullinger AG, Association of occlusal variables among refined TM patients diagnostic groups. J Craniomandib Disord. 1989; 3(4): 227-36.
Dworkin SF, Huggins KH, LeResche L, Von Korff M, Howard J, E Truelove, et al. Epidemiology of signs and symptoms in temporomandibular disorders: clinical signs in cases and controls. J Am Dent Assoc. 1990; 120(3): 273-81. DOI: https://doi.org/10.14219/jada.archive.1990.0043
Pullinger AG, Seligman DA. Overbite and overjet characteristics of refined diagnostic groups of temporomandibular patients. Am J Orthod Dentofacial Orthop. 1991; 100(5): 401-15. DOI: https://doi.org/10.1016/0889-5406(91)70079-c
Steele JG, Lamey PJ, Sharkey SW, Smith GM. Occlusal abnormalities, pericranial muscle and joint tenderness and tooth wear in a group of migraine patients. J Oral Rehabil. 1991; 18(5): 453-8. DOI: https://doi.org/10.1111/j.1365-2842.1991.tb01690.x
Cacchiotti DA, Plesh O, Bianchi P, McNeill C. Signs and symptoms in sample with and without temporomandibular disorders. J Craniomandib Disord. 1991; 5(3): 167-72.
Könönen M, Wenneberg B, Kallenberg A. Craniomandibular disorders in rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis: a clinical study. Acta Odontol Scand. 1992; 50(5): 281-7. DOI: https://doi.org/10.3109/00016359209012774
Pullinger AG, Seligman DA, Gornbein JA. A multiple logistic regression analysis of the risk and relative odds of temporomandibular disorders as a function of common occlusal features. J Dent Res. 1993; 72(6): 968-79. DOI: https://doi.org/10.1177/00220345930720061301
Seligman DA, Pullinger AG. A multiple stepwise logistic regression analysis of trauma history and 16 other history and dental cofactors in females with temporomandibular disorders. J Orofac Pain. 1996; 10(4): 351-61.
Tsolka P, Fenlon MR, McCullock AJ, Preiskel HW. A controlled clinical, electromyographic, and kinesiographic assessment of craniomandibular disorders in women. J Orofac Pain. 1994; 8(1): 80-9.
Tsolka P, Walter JD, Wilson RF, Preiskel HW. Occlusal variables, bruxism, and temporomandibular disorders: a clinical and kinesiographic assessment. J Oral Rehabil. 1995; 22(12): 849-56. DOI: https://doi.org/10.1111/j.1365-2842.1995.tb00233.x
Raustia AM, Pirttiniemi PM, Pyhtinen J. Correlation of occlusal factors and condyle position asymmetry with signs and symptoms of temporomandibular disorders in young adults. J Craniomandib Pract. 1995; 13(3): 152-6. DOI: https://doi.org/10.1080/08869634.1995.11678060
Kahn J, Tallents RH, Katzberg RW, Moss ME, Murphy WC. Association between dental occlusal variables and intraarticular temporomandibular joint disorders: horizontal and vertical overlap. J Prosthet Dent. 1998; 79(6): 658-62. DOI: https://doi.org/10.1016/S0022-3913(98)70072-1
Kahn J, Tallents RH, Katzberg RW, Moss ME, Murphy WC. Prevalence of dental occlusal variables and intraarticular temporomandibular disorders: Molar relationship, lateral guidance, and nonworking side contacts. J Prosthet Dent. 1999; 82(4): 410-5. DOI: https://doi.org/10.1016/s0022-3913(99)70027-2
Pullinger AG, Seligman DA. Quantification and validation of predictive values of occlusal variables in temporomandibular disorders using a multifactorial analysis. J Prosthet Dent. 2000; 83(1): 66-75. DOI: https://doi.org/10.1016/s0022-3913(00)70090-4
Seligman DA, Pullinger AG. Analysis of occlusal variables, dental attrition, and age for distinguishing healthy controls from females patients with intracapsular temporomandibular disorders. J Prosthet Dent. 2000; 83(1): 76-82. DOI: https://doi.org/10.1016/s0022-3913(00)70091-6
List T, Wahlund K, Larsson B. Psychosocial functioning and dental factors in adolescents with temporomandibular disorders: a case-control study. J Orofac Pain. 2001; 15(3): 218-27.
Macfarlane TV, Gray RJM, Kincey J, Worthington HV. Factors associated with the temporomandibular disorder, pain dysfunction syndrome (PDS): Manchester case-control study. Oral Dis. 2001; 7(6): 321-30. DOI: https://doi.org/10.1034/j.1601-0825.2001.00758.x
Yamakawa M, Ansai T, Kasai S, Ohmaru T, Takeuchi H, Kawaguchi T, et al. Dentition status and temporomandibular joint disorders in patients with rheumatoid arthritis. Carnio. 2002; 20(3): 165-70. DOI: https://doi.org/10.1080/08869634.2002.11746207
Tallents RH, Macher DJ, Kyrkanides S, Katzberg RW, Moss ME. Prevalence of missing posterior teeth and intraarticular temporomandibular disorders. J Prosthet Dent. 2002; 87(1): 45-50. DOI: https://doi.org/10.1067/mpr.2002.121487
John MT, Frank H, Lobbezzo F, Drangsholt M, Dette KE. No association between incisal wear and temporomandibular disorders. J Prosthet Dent. 2002; 87(2): 197-203. DOI: https://doi.org/10.1067/mpr.2002.121167
Fujii T. Occlusal conditions just after the relief of temporomandibular joint and masticatory muscle pain. J Oral Rehabil. 2002; 29(4): 323-29. DOI: https://doi.org/10.1046/j.1365-2842.2002.00835.x
Landi N, Manfredini D, Tognini F, Romagnoli M, Bosco M. Quantification of the relative risk of multiple occlusal variables for muscle disorders of the stomatognathic system. J Prosthet Dent. 2004; 92(2): 190-5. DOI: https://doi.org/10.1016/j.prosdent.2004.05.013
Selaimen CM, Jeronymo JC, Brilhante DP, Lima EM, Grossi PK, Grossi ML. Occlusal risk factors for temporomandibular disorders. Angle Orthod. 2007; 77(3): 471-7. DOI: https://doi.org/10.2319/0003-3219(2007)077[0471:orfftd]2.0.co;2
Takayama Y, Miura E, Yuasa M, Kobayashi K, Hosoi T. Comparison of occlusal condition and prevalence of bone change in the condyle of patients with and without temporomandibular disorders. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008; 105(1): 104-12. DOI: https://doi.org/10.1016/j.tripleo.2006.12.033
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
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
Pullinger AG, Monteiro AA. History factors associated with symptoms of temporomandibular disorders. J Oral Rehabil. 1998; 15(2): 117-24. DOI: https://doi.org/10.1111/j.1365-2842.1988.tb00760.x
Egermark I, Thilander B. Craniomandibular disorders with special reference to orthodontic treatment: an evaluation from childhood to adulthood. Am J Orthod Dentofacial Orthop. 1992; 101(1): 28-34. DOI: https://doi.org/10.1016/0889-5406(92)70078-o
Katzberg RW, Westesson PL, Tallents RH, Drake CM. Orthodontics and tem oromandibuler joint internal derangment. Am J Orthod Dentofacial Orthop. 1996; 109(5): 515-20. DOI: https://doi.org/10.1016/s0889-5406(96)70136-1
Tallents RH, Katzberg RW, Murphy W, Proskin H. Magnetic resonance imaging finding in asymptomatic volunteers and symptomatic patients with temporomandibular disorders. J Prosthet Dent. 1996; 75(5): 529-33. DOI: https://doi.org/10.1016/s0022-3913(96)90458-8
Huang Gj, LeResche L, Critchlow, Martin MD, Drangsholt MT. Risk factors for diagnostic subgroups of painful temporomandibular disorders (TMD). J Dent Res. 2002; 81(4): 284-8. DOI: https://doi.org/10.1177/154405910208100412
Velly AM, Gornitsky M, Philippe P. A case-control study of temporomandibular disorders: symptomactic disc displacement. J Oral Rehabil. 2002; 29(5): 408-16. DOI: https://doi.org/10.1046/j.1365-2842.2002.00913.x
Velly AM, Gornitsky M, Philippe P. Heterogenecity of temporomandibular disorders: cluster and case-control study analyises. J Oral Rehabil. 2002; 29(10): 969-79. DOI: https://doi.org/10.1046/j.1365-2842.2002.00984.x
Mohlin BO, Derweduwen K, Pilley R, Kingdon A, Shaw WC, Kenealy P. Malocclusion and temporomandibular disorder: A comparison of adolecents with moderate to severe dysfunction with those without signs and symptoms of temporomandibular disorders and their futher development to 30 years of age. Angle Orthod. 2004; 74(3): 319-27. DOI: https://doi.org/10.1043/0003-3219(2004)074%3C0319:matdco%3E2.0.co;2
Macfarlane TV, Kenealy P, Kingdon HA, Mohlin BO, Pilley JR, Richmond S, et al. Twenty-year cohort study of health gain from orthodontic treatment: temporomandibular disorders. Am J Orthod Dentofacial Orthop. 2009; 135(6): 692-3. DOI: https://doi.org/10.1016/j.ajodo.2008.10.017
Egermark-Eriksson I, Carlsson GE, Magnusson T, Thilander B. A longitudinal study on malocclusion in relation to signs and symptoms of craniomandibular disorders in children and adolescents. Eur J Orthod. 1990; 12(4): 399-407. DOI: https://doi.org/10.1093/ejo/12.4.399
Carlsson GE, Egermark I, Magnusson T. Predictors of signs and symptoms of temporomandibular disorders: a 20-year follow-up study from childhood to adulthood. Acta Odontol Scand. 2002; 60(3): 180-5. DOI: https://doi.org/10.1080/000163502753740214
Magnusson T, Egermarki I, Carlsson GE. A prospective investigation over two decades on signs and symptoms of temporomandibular disorders and associated variables: a final summary. Acta Odontol Scand. 2005; 63(2): 99-109. DOI: https://doi.org/10.1080/00016350510019739
Magnusson T, Enbom L. Signs and symptoms of mandibular dysfunction after introduction of experimental balancing-side interferences. Acta Odontol Scand. 1984; 42(3): 129-35. DOI: https://doi.org/10.3109/00016358408993863
Le Bell Y, Jämsä T, Korri S, Niemi PM, Alanen P. Effect of artificial occlusal interferences depends on previous experience of temporomandibular disorders. Acta Odontol Scand. 2002; 60(4): 219-22. DOI: https://doi.org/10.1080/000163502760147981
Le Bell Y, Jämsä T, Korri S, Niemi PM, Alanen P. Effect of artificial occlusal interferences depends on previous experience of temporomandibular disorders. Acta Odontol Scand. 2006; 60(4): 59-63. DOI: https://doi.org/10.1080/000163502760147981
Kirveskari P, Le Bell Y, Salonen M, Forssell H, Grans L. 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
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
Tsolka P, Marvis PW, 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
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
Henrikson T, Nilner M. Temporomandibular disorders and the need for stomatognathic treatment in orthodontically treated and untreated girls. Eur J Orthod. 2000; 22(3): 283-92. DOI: https://doi.org/10.1093/ejo/22.3.283
Henrikson T, Nilner M, Kurol J. Signs of temporomandibular disorders in girls receiving orthodontic treatment: a prospective and longitudinal comparison with untreated Class II malocclusions and normal occlusion subjects. Eur J Orthod. 2000; 22(3): 271-81. DOI: https://doi.org/10.1093/ejo/22.3.271
Henrikson T, Nilner M. Temporomandibular disorders, occlusion and orthodontic treatment. J Orthod. 2003; 30(2): 129-37. DOI: https://doi.org/10.1093/ortho/30.2.129
Slade GD, Diatchenko L, Orbach R, Maixner W. Orthodontic treatment, genetic factors, and risk of temporomandibular disorders. Semin Orthod. 2008; 14(2): 146-56. DOI: https://doi.org/10.1053/j.sodo.2008.02.005
Egermark I, Magnusson T, Carlsson GE. A prospective study of signs and symptoms of temporomandibular disorders in patients who received orthodontic treatment in childhood. Angle Orthod. 2003; 75(4): 645-50. DOI: https://doi.org/10.1043/0003-3219(2005)75[645:aplsos]2.0.co;2
Egermark I, Magnusson T, Carlsson GE. A 20-year follow- up of signs and symptoms of temporomandibular disorders and malocclusion in subjects with and without orthodontic treatment in childhood. Angle Orthod. 2003; 73(2): 109-15. DOI: https://doi.org/10.1043/0003-3219(2003)73%3C109:ayfosa%3E2.0.co;2
Mohlin C. From bite to mind: TMD a personal and literature review. Inter J Prosthodont. 1999; 12(3): 279-88.
Green CS. Concepts of TMD etiology: effects on diagnosis and treatment. En: Laskin DM, Greene CS, Hylander WL. Temporomandibular disorders: an evidence-based approach to diagnosis and treatment. Chicago: Quintessence Pubblishing; 2006.
Sessle BJ, Lavigne GJ, Lund JP, Dubner R. Orofacial pain: from basic science to clinical management. 2.ª ed. Chicago: Quintessence Pubblishing; 2008.
De Boever JA, Carlsson GE. Etiology and differential diagnosis. En: Zarb GA, Carlsson GE, Sessle BJ, Mohl ND, eds. Temporomandibular joint and masticatory muscle disorders. Copenhagen: Munksgaard; 1994.
Parker MW. A dynamic model of etiology in temporomandibular disorders. J Am Dent Assoc. 1990; 120(3): 283-90. DOI: https://doi.org/10.14219/jada.archive.1990.0045
Woda A, Pionchon P. A unified concept of idiopathic orofacial pain: clinical features. J Orofac Pain. 1999; 13(3): 172-84.
Woda A, Pionchon P. A unified concept of idiopathic orofacial pain: pathophysiologic features. J Orofac Pain. 2000; 14(3): 196-212.
Aggarwal VR, McBeth J, Lunt M, Zakrzewska JM, Macfarlane GJ. Development and validation of classification criteria for idiopathic orofacial pain for use in population- based studies. J Orofac Pain. 2007; 21(3): 203-15.
Svensson P, Arendt-Nielson L. Clinical and experimental aspects of temporomandibular disorders. Curr Rev Pain. 2000; 4(2): 158-65. DOI: https://doi.org/10.1007/s11916-000-0051-1
Greene CS, Laskin DM. Temporomandibular disorders: moving from a dentally based to a medically based model. J Dent Res. 2000; 79(10): 1736-9. DOI: https://doi.org/10.1177/00220345000790100101
Suvinen TI, Reade PC, Kemppainen P, Könönen M, Dworkin SF. Review of aetiological concepts of temporomandibular pain disorders: towards a biopsychosocial model for integration of physical disorder factors with psychological and psychosocial illness impact factors. Eur J Pain. 2005; 9(6): 613-33. DOI: https://doi.org/10.1016/j.ejpain.2005.01.012
Oakley M. Vieira AR. The many faces of the genetics contribution to temporomandibular joint disorder. Orthod Craniofacial Res. 2008; 11(3): 125-35. DOI: https://doi.org/10.1111/j.1601-6343.2008.00426.x
Fillingim RB, Wallace MR, Herbstman DM, Ribeiro-Dasilva M. Staud R. Genetic contributions to pain: a review of findings in humans. Oral Diseases. 2008; 14(8): 673-82. DOI: https://doi.org/10.1111%2Fj.1601-0825.2008.01458.x
Stohler CS. A genetic vulnerability disorder with strong CNS involvement. J Evid Base Dent Pract. 2006; 6: 53-57.
Diatchenko L, Salde GD, Nackley AG, Bhalang K, Sigurdsson A, Belfer I, et al. Genetic basis for individual variation in pain perception and the development of chronic pain condition. Hum Mol Genet. 2005; 14(1): 135-43. DOI: https://doi.org/10.1093/hmg/ddi013
Clark GT, Tsukiyama Y, Baba K, Watanabe T. Sixty-eight years of experimental occlusal interference studies: what have we learned? J Prosthet Dent. 1999; 82(6): 704-13. DOI: https://doi.org/10.1016/s0022-3913(99)70012-0
Aggarwal VR, McBeth J, Zakrzewska JM, Lunt M, Macfarlane GJ. Are reports of mechanical dysfunction in chronic orofacial pain related to somatisation? A population-based study. Eur J Pain. 2008; 12(4): 501-7. DOI: https://doi.org/10.1016/j.ejpain.2007.08.002
Schur EA, Afari N, Furberg H, Olarte M, Goldberg J, Sullivan PF, et al. Feeling bad in more ways than one: co- morbidity patterns of medically unexplained and psychiatric conditions. J Gen Inter Med. 2007; 22(6): 818-21. DOI: https://doi.org/10.1007%2Fs11606-007-0140-5
Aggarwal VR, McBeth J, Zakrzewska JM, Lunt M, Macfarlane GJ. The epidemiology of chronic syndromes that are frequently unexplained: do they have common associated factors? Inter J Epidemiol. 2006; 35(2): 468-76. DOI: https://doi.org/10.1093/ije/dyi265
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