Occlusal risk factors for temporomandibular disorders.
OBJECTIVE
To determine the role of occlusal variables (overbite; overjet; number of anterior and posterior teeth; bilateral canine guidance on lateral and protrusive movements; anterior centric slide; Angle Classes I, II, and III malocclusion) as risk indicators for the development of temporomandibular disorders (TMDs).


METHODS
Seventy-two TMD patients with myofascial pain, with or without limited opening and arthralgia, as well as 30 age- and gender-matched pain-free concurrent controls were included. The association (critical odds ratio [OR] = 2.0) between the significant occlusal variables and TMD was calculated. Confounders were controlled in the inclusion-exclusion criteria as well as in the analysis stage (unconditional logistic regression) by variation in the OR (15%).


RESULTS
Angle Class II malocclusion (crude OR = 8.0, confidence interval [CI] = 2.2 to 29.3) and the absence of bilateral canine guidance on lateral excursion (crude OR = 3.9, CI = 1.6 to 9.7) were statistically more common in patients than in controls. Spontaneous pain as well as pain on palpation (Class II or higher) were also statistically worse in TMD patients. Significant confounders (ie, employment, age, cigarette and alcohol consumption) acted as effect modifiers not changing the critical OR (adjusted OR Angle Class II and bilateral canine guidance = 8.3 to 12.4 and 2.2 to 4.1, respectively).


CONCLUSIONS
Absence of bilateral canine guidance on lateral excursion and particularly Angle Class II malocclusion were considered important risk indicators for the development of TMD in this investigation, even when some sociodemographic factors were considered as effect modifiers.
Selaimen
Caio M P
CM
Faculty of Dentistry, Pontifical Catholic University of Rio Grande do Sul--PUCRS, Brazil.
Jeronymo
José C M
JC
Brilhante
Diego P
DP
Lima
Eduardo M
EM
Grossi
Patrícia K
PK
Grossi
Márcio L
ML
D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects; D016022:Case-Control Studies; D003481:Cuspid; D003710:Demography; D005157:Facial Pain / Q000209:etiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008310:Malocclusion / Q000150:complications*; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D012959:Socioeconomic Factors; D013705:Temporomandibular Joint Disorders / Q000209:etiology*