Reevaluation of occlusal treatment for temporomandibular disorders

Abstract

A retrospective study was performed using two treatment groups of unilateral TMD patients in order to evaluate the influence of the occlusal factors to the treatment results.
One group comsisted of 193 patients treated with the procedures including a stabilization type appliance and/or an occlusal adjustment procedure, and the other group consisted of 189 patients treated with the other procedures without stabilization appliance or occlusal adjustment.
The factors investigated were as follows: Angle classification II or III, overbite over 5mm, overjet over 5mm, lost of molar support, decreased vertical dimension, premature contact, occlusal contact on nonworking side, undesirable anterior guidance, history of trauma to the mandible, experience of orthodontic treatment, and night bruxism.
The treatment procedures, except for stabilization type appliance therapy and occlusal adjustment, included education for life style, medication, joint moving exercise, muscle stretching exercise, muscle loading exercise, repositioning type appliance therapy, pivoting type appliance therapy, night guard, disk repositioning manipulation, gum chewing exercise, psychological counseling, and acupuncture.
The results suggested that either the stabilization type appliance treatment or the occlusal adjustment procedure for the purpose of avoidance or improvement of occlusal problems were not necessary to improve the symptoms of TMD patients. The logistic regression analysis suggested that the factor other than the investigated factors might be associated with maintaining the symptoms.