An evidence-based assessment of occlusal adjustment as a treatment for temporomandibular disorders.
BACKGROUND
Occlusal adjustment therapy has been advocated as a treatment modality for temporomandibular disorders. In contrast to this position, a panel at the 1996 National Institute of Health technology assessment conference on TMD indicated that no clinical trials demonstrate that occlusal adjustment is superior to noninvasive therapies.


OBJECTIVE
This article summarizes the published experimental studies on occlusal adjustments and temporomandibular disorders.


METHODS
Eleven research experiments involving 413 subjects with either bruxism (n = 59), temporomandibular disorders (n = 219), headaches and temporomandibular disorders (n = 91), or chronic cervical pain (n = 40) were selected for critical review from the English dental literature.


RESULTS
Three experiments evaluated the relationship between occlusal adjustment and bruxism. Six experiments evaluated occlusal adjustment therapy as a treatment for patients with primary temporomandibular disorders. One experiment looked at occlusal adjustment effect on headache/temporomandibular disorder symptoms; another looked at its effect on chronic neck pain. Most of these experiments used a mock adjustment or a comparison treatment as the control condition in adults who had an existing nonacute general temporomandibular disorder. Overall, the data from these experiments did not demonstrate elevated therapeutic efficacy for occlusal adjustment over the control or the contrasting therapy.


CONCLUSIONS
The experimental evidence reviewed was neither convincing nor powerful enough to support the performance of occlusal therapy as a general method for treating a nonacute temporomandibular disorder, bruxism, or headache.
Tsukiyama
Y
Y
Faculty of Dental Science, Kyushu University, Fukuoka, Japan.
Baba
K
K
Clark
G T
GT
D000328:Adult; D000779:Anesthetics, Local / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001623:Betamethasone / Q000627:therapeutic use; D001676:Biofeedback, Psychology; D002012:Bruxism / Q000628:therapy; D002908:Chronic Disease; D003376:Counseling; D004576:Electromyography; D019317:Evidence-Based Medicine; D005500:Follow-Up Studies; D006261:Headache / Q000628:therapy; D006801:Humans; D007270:Injections, Intra-Articular; D008012:Lidocaine / Q000627:therapeutic use; D009334:Neck Muscles / Q000503:physiopathology; D019547:Neck Pain / Q000628:therapy; D019558:Occlusal Adjustment; D017090:Occlusal Splints; D010919:Placebos; D020186:Sleep Bruxism / Q000503:physiopathology / Q000628:therapy; D013705:Temporomandibular Joint Disorders / Q000628:therapy*
D000779:Anesthetics, Local; D000893:Anti-Inflammatory Agents; D010919:Placebos; D001623:Betamethasone; D008012:Lidocaine