Research abstract
British Dental Journal 202, E3 (2007)
Published online: 13 January 2007 | doi:10.1038/bdj.2006.123
TMD and occlusion part II. Damned if we don't? Functional occlusal problems: TMD epidemiology in a wider context
F. Luther1
- Reviews and investigates relationships between functional occlusion and TMD.
- Reviews and investigates relationships between bruxism and TMD.
- Reviews the aetiology of bruxism.
- Highlights the need for clinicians to consider the quality of evidence as TMD is placed in a wider context, including epidemiological aspects of musculoskeletal disease and factors relating to cause and effect.
- Aims to place the problem of TMD in a wider context and illustrate the need for a more coherent explanation of the disease profile actually seen, so that more informed advice can be given to patients and more informed treatment decisions can be made.
Abstract
Objectives To review studies investigating how functional occlusion may relate to TMD and how bruxism may relate to TMD; to review the epidemiology of TMD and relate this to the context of clinical occlusal studies and other aetiological factors. Deficiencies in study design are highlighted and suggestions made to improve future study designs in order to provide an evidence-base for clinical practice.
Design Review article.
Methods Electronic databases (MEDLINE and the Cochrane Database of Systematic Reviews) were used to select relevant and frequently cited studies (mean: 40 citations). Citation rate was confirmed using the Web of Science. Study designs are reviewed and weaknesses and implications discussed.
Results Evidence is lacking to suggest functional occlusal factors cause TMD. Investigation of other aetiological factors has been relatively neglected.
Conclusions Neither static nor dynamic occlusal factors (including orthodontics) can be said to 'cause' TMD. However, other potential aetiological factors exist which would benefit from more investigation. This, together with improved study designs, would help provide a stronger evidence-base for clinical practice in the future.
- Head of Academic Orthodontics, Department of Orthodontics, Child Dental Health, Leeds Dental Institute, Clarendon Way, Leeds, LS2 9LU
Correspondence to: F. Luther1 e-mail: f.luther@leeds.ac.uk
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