Malocclusion and the need for orthodontic treatment in patients with temporomandibular dysfunction (original) (raw)
Related papers
Relationship Between Orthodontics and Temporomandibular Disorders: A Prospective Study
Journal of oral & facial pain and headache, 2016
To investigate the possible relationship between the orthodontic treatment of Class II malocclusion and the development of temporomandibular disorders (TMD). A total of 40 patients was evaluated at four time points: the day before the start of treatment employing bilateral Class II elastics (baseline), as well as at 24 hours, 1 week, and 1 month after the start of treatment. The development of TMD pain complaints in the orofacial region and changes in the range of mouth opening were assessed at these times. Shapiro-Wilk, McNemar, and Friedman tests with 5% significance level were used to analyze the data. The treatment produced pain of a transitory, moderate intensity, but there was no significant change from baseline after 1 month. There were no restrictions in the range of jaw motion or any evidence of limitations in mouth opening. Orthodontic treatment with bilateral Class II elastics does not cause significant orofacial pain or undesirable changes in the range of mouth opening. ...
The role of orthodontics in temporomandibular disorders
Journal of Oral Rehabilitation, 2010
Temporomandibular Disorder (TMD) is the main cause of pain of non-dental origin in the oro-facial region including head, face and related structures. The aetiology and the pathophysiology of TMD is poorly understood. It is generally accepted that the aetiology is multifactorial, involving a large number of direct and indirect causal factors. Among such factors, occlusion is frequently cited as one of the major aetiological factors causing TMD. It is well known from epidemiologic studies that TMD-related signs and symptoms, particularly temporomandibular joint (TMJ) sounds, are frequently found in children and adolescents and show increased prevalence among subjects between 15 and 45 years old. Aesthetic awareness, the development of new aesthetic orthodontic techniques and the possibility of improving prosthetic rehabilitation has increased the number of adults seeking orthodontic treatment. The shift in patient age also has increased the likelihood of patients presenting with signs and symptoms of TMD. Because orthodontic treatment lasts around 2 years, orthodontic patients may complain about TMD during or after treatment and orthodontists may be blamed for causing TMD by unsatisfied patients. This hypothesis of causality has led to legal problems for dentists and orthodontists. For these reasons, the interest in the relationship between occlusal factors, orthodontic treatment and TMD has grown and many studies have been conducted. Indeed, claims that orthodontic treatment may cause or cure TMD should be supported by good evidence. Hence, the aim of this article is to critically review evidence for a possible association between malocclusion, orthodontic treatment and TMD.
Orthodontics is temporomandibular disorder–neutral
The Angle Orthodontist, 2015
Objectives: To assess if subjects with a clinical diagnosis of temporomandibular disorders (TMDs) have a similar prevalence of orthodontic history as a population of TMD-free individuals and to assess if those subjects who have a history of ideal orthodontics have fewer symptoms than those with a history of nonideal orthodontics. Materials and Methods: Two groups of age- and sex-matched individuals belonging to either a study (“TMD”) or a control group were recruited. Subjects who underwent orthodontic treatment were classified as having a history of ideal or nonideal orthodontics based on the current presence of normal values in five reference occlusal features. Results: The correlation with a history of orthodontic treatment was not clinically significant for any of the TMD diagnoses (ie, muscle pain, joint pain, disc displacement, arthrosis), with Phi (Φ) coefficient values within the −0.120 to 0.058 range. Within the subset of patients with a history of orthodontics, the corr...
Manfredini et al 2016 Orthodontics is TMD-neutral
Objectives: To assess if subjects with a clinical diagnosis of temporomandibular disorders (TMDs) have a similar prevalence of orthodontic history as a population of TMD-free individuals and to assess if those subjects who have a history of ideal orthodontics have fewer symptoms than those with a history of nonideal orthodontics. Materials and Methods: Two groups of age-and sex-matched individuals belonging to either a study ("TMD") or a control group were recruited. Subjects who underwent orthodontic treatment were classified as having a history of ideal or nonideal orthodontics based on the current presence of normal values in five reference occlusal features. Results: The correlation with a history of orthodontic treatment was not clinically significant for any of the TMD diagnoses (ie, muscle pain, joint pain, disc displacement, arthrosis), with Phi (W) coefficient values within the 20.120 to 0.058 range. Within the subset of patients with a history of orthodontics, the correlation of ideal or nonideal orthodontic treatment with TMD diagnoses was, in general, not clinically relevant or was weakly relevant. Conclusions: Findings confirmed the substantial absence of clinically significant effects of orthodontics as far as TMD is concerned. The very low correlation values of a negative or positive history of ideal or nonideal orthodontics with the different TMD diagnoses suggest that orthodontic treatment could not have a true role for TMD.
Relationship between Orthodontics and Temporomandibular Disorders
Since the end of the 20 th century, the problems of the temporomandibular disorders (TMDs) have aroused interest to the orthodontists. The aim of this literature review is to present the contemporary evidence concerning the association between the presence of malocclusions and the occurrence of signs and symptoms of the TMJ. In addition, additional variables, which may affect the TMJs of a patient during the orthodontic treatment are pointed out. It is evident that there is an increased number of patients who are seeking for orthodontic treatment, not only in order to enhance their facial aesthetics and the function of mastication system, but also to relieve the symptoms of the temporomandibular joint (TMJ). There are multiple etiological factors that have been associated with the TMDs and they may be manifested by pain and/or sounds of TMJ. In addition, during the clinical examination it can be detected a deviation from the normal function of the mandible.
Cranio : the journal of craniomandibular practice, 2017
The aim of this study was to identify clinical factors predisposing to the development or worsening of temporomandibular disorders (TMDs) following orthodontic surgical treatment for Class III malocclusion. A retrospective cohort study was performed on 88 patients with Class III malocclusion having undergone a combined orthodontic and orthognathic surgical treatment. Temporomandibular joint and masticatory muscle examinations were available prior to treatment and one year post-operatively. Multivariate logistic regression was used to predict the development of post-operative TMDs, and linear regression was used to predict the worsening of TMDs using Helkimo indices. Patients with Class III malocclusion presenting with pre-treatment anamnestic TMJ clicking (OR = 5.8; p = 0.03) and undergoing bimaxillary osteotomy procedures (OR = 18.6; p = 0.04) were more at risk for the development of TMDs. TMDs must be evaluated, monitored, and managed with caution in patients with Class III malocc...
Orthodontic Treatment a Boon or Bane to TMJ
Abstract: TMJ disorders are a complication in itself. The orthodontic treatment is considered sometimes as a remedy for the TMJ disorders whereas other few times the same is considered as culprit. The common problems encountered in the clinical practice are Class II cases. Therefore the treatment plans for the cases are taken into consideration for the study. The main aim of the study is to determine, does Orthodontic treatment will cause TMD disorder or an remedy for TMD disorders.A Sample of 100 Patients between the age group of 10-22 yrs were taken for the Study, divided into two groups depending on the case and treatment plan. It was observed that during the course of the treatment patients of 1stgroup that is Class II Div2 experience less pain and the severity was reduced this might me due to the forward displacement of mandible when the incisors weretorquedlabially so there was less compression on the retrodiscal tissue and hencethe pain was reduced.In group 2 Patients those subjected to Head gear experienced little pain.Thereby, the study enlightens about the relationship of orthodontics & TMJ disorders.
Assessment of temporomandibular disorder and occlusion in treated class III malocclusion patients
Journal of Applied Oral Science, 2007
The aims of this study were to compare the prevalence of temporomandibular disorders (TMD) in individuals submitted to either orthodontic or ortho-surgical Class III malocclusion treatment and to assess the influence of occlusal aspects on TMD severity. Material and methods: The sample consisted of 50 individuals divided into two groups, according to the type of treatment (orthodontic or orthodontic with orthognathic surgery). The presence of signs and symptoms of TMD was evaluated by an anamnestic questionnaire and a clinical examination, including TMJ and muscle palpation, active mandibular range of motion, joint noises and occlusal examination. Results: Based on the anamnestic questionnaire, 48% had no TMD, 42% had mild TMD and 10% had moderate TMD. The presence and severity of TMD did not show any relationship with the type of orthodontic treatment (p>0.05). The chi-square test showed a positive association (p<0.05) between TMD and nonworking side occlusal interferences. Conclusion: Based on the methodology used and the results obtained, it may be concluded that Class III orthodontic treatment was not associated with the presence of TMD signs and symptoms and the non-working side contacts can be occlusal factors of risk. There was no significant difference in TMD prevalence between the studied groups (orthodontically treated patients and patients treated with orthodontics followed by orthognathic surgery).
Orthodontic treatment and temporomandibular joint disorders
American Journal of Orthodontics and Dentofacial Orthopedics, 1992
The overall objective of this project was to study the relationship between orthodontic treatment and temporomandibular joint (TMJ) disorders. This relationship has been and remains an important and complex issue in orthodontics. The objectives of the study were to determine the incidence of TMJ pain and dysfunction in a group of orthodontic patients who were symptom-free on entering treatment, and to assess and characterize the level of pain and dysfunction in patients with symptoms, and track changes in these parameters during the course of orthodontic treatment. Standardized functional indices and physical measurements were used to describe and assess TMJ pain and dysfunction. The results of this study showed that of 451 patients without symptoms undergoing treatment at our university clinic during the 18-month project, no patient developed signs and symptoms of TMJ disorders during that time. In addition, for the 11 patients who presented with signs and symptoms of TMJ disorders at the time of their entry into the treatment program, no clear or consistent changes in levels of pain and dysfunction occurred longitudinally during the treatment period followed in this study. On the basis of these findings, a relationship between either the onset of TMJ pain and dysfunction and the course of orthodontic treatment or the change in TMJ pain and dysfunction and the course of orthodontic treatment could not be established in this particular patient population. (AM J ORTHOD DENTOFAC ORTHOP 1992;101:84-7.) The relationship between orthodontic treatment and temporomandibular joint (TMJ) disorders is currently an important issue in orthodontics and one that is characterized by conflicting viewpoints concerning the question of whether orthodontic treatment can either resolve, induce, or have little or no effect on TMJ pain and dysfunction, v" Most of the previous attempts at relating TMJ pain and dysfunction to orthodontic treatment have been based on either anecdotal evidence or retrospective studies, approaches that cannot demonstrate a cause-and-effect relationship between treatment and disease. An alternative approach to this problem is to study a group of patients prospectively during the course of orthodontic treatment. Prospective longitudinal studies provide new types of information, and also represent the best method for elucidating any underlying cause-and-effect relationship between orthodontic treatment and TMJ disorders.