Occlusal adjustment and the incidence of demand for temporomandibular disorder treatment.
BACKGROUND
Contrary to clinical opinion, the structural risk from dental occlusion in temporomandibular disorders has been questioned or considered to be insignificant in clinical practice.


OBJECTIVE
This study tested the effect of elimination of occlusal interference through occlusal adjustment, on the incidence of temporomandibular disorders.


METHODS
In a controlled clinical trial of 146 healthy children and adolescents, half of the subjects underwent occlusal adjustment aimed at elimination of the presumed structural risk, and the other half underwent mock adjustment. Adjustments were repeated every 6 months over a period of 4 years. The outcome variable was the incidence of temporomandibular disorders, operatively defined as request for treatment of symptoms characteristic of the disorders with presence of clinical signs demonstrated in the muscles of mastication and/or jaw joint.


RESULTS
The cumulative incidence rate was 9/67 in the mock adjustment group and 1/60 in the real adjustment group, for a relative risk of 8.06. The difference between groups was statistically significant (p = 0.019).


CONCLUSIONS
Elimination of the presumed structural risk from the dental occlusion appeared to significantly reduce the incidence of temporomandibular disorders in a select group of young subjects.
Kirveskari
P
P
Department of Stomatognathic Physiology, Institute of Dentistry, University of Turku, Finland.
Jamsa
T
T
Alanen
P
P
D000293:Adolescent; D000328:Adult; D016302:Centric Relation; D002648:Child; D003766:Dental Occlusion; D003769:Dental Occlusion, Traumatic / Q000628:therapy; D004311:Double-Blind Method; D005157:Facial Pain / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008410:Masticatory Muscles / Q000503:physiopathology; D019558:Occlusal Adjustment; D012307:Risk Factors; D013705:Temporomandibular Joint Disorders / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome