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Manfredini D, Poggio CE. J Prosthet Dent 2017;117: 606–613

The investigators asked the following pertinent questions: 1) has prosthetic reconstruction any role in the treatment of TMDs and/or bruxism compared with other treatment approaches, 2) can prosthodontic treatment cause these perturbations, and 3) can prosthodontics be safely carried out for those with TMDs and/or bruxism? Notwithstanding that no papers were of sufficient quality for inclusion in the systematic review, these authors provide some insightful comments. Prosthetic rehabilitation has no place in the treatment of those with TMDs and/or bruxism and indeed such treatment could exacerbate TMDs. Although oral appliances may facilitate reorganisation of muscle fibres and 'a shift in the area of highest joint loading', irreversible reconstructive dentistry has no role in the treatment of TMDs and/or bruxism. Although there was no clear steer as to whether or not prosthetic reconstruction can be carried out in those patients who have TMDs and/or bruxism, the investigators did suggest it would be wise not to carry out 'occlusal modifications (rehabilitation) that jeopardize the capacity for accommodation.