ABSTRACT

Temporomandibular joint disorders (TMDs) are common conditions affecting the temporomandibular joint, masticatory muscles, and related structures. They often cause orofacial pain, joint sounds, and limitations in mandibular movement. For many years, the relationship between malocclusion, orthodontic treatment, and TMD has been widely discussed. In the past, it was suggested that orthodontic treatment could improve TMD symptoms by correcting occlusal relationships and reducing mechanical stress on the joint. However, current scientific evidence does not support a direct or causal link between specific malocclusion types and TMD. Recent studies indicate that TMD has a multifactorial etiology, in which psychosocial factors, parafunctional habits, trauma, and individual adaptation play a more important role than occlusion alone. Systematic reviews and long-term prospective studies show that orthodontic treatment is not a primary treatment option for TMD and does not increase the risk of developing these disorders. Improvements in TMD symptoms reported during or after orthodontic treatment are often related to the natural course of the condition, psychosocial adaptation, or nonspecific treatment effects rather than to direct biomechanical changes. This review aims to evaluate the relationship between orthodontic treatment and temporomandibular joint disorders based on current evidence and to provide clinicians with a clear and evidence-based perspective for clinical practice.

KEYWORDS

Temporomandibular disorders; Orthodontic treatment; Temporomandibular joint; Malocclusion; Biopsychosocial model

REFERENCES

1) Okeson, J.P. and J.P. Ckeson, Management of temporomandibular disorders and occlusion. 2013: Elsevier/Mosby St. Louis, MO.
2) Bove, S.R.K., A.S. Guimarães, and R.L. Smith, Caracterização dos pacientes de um ambulatório de disfunção temporomandibular e dor orofacial. Revista latino-americana de Enfermagem, 2005. 13: p. 686-691.
3) McNeill, C., Management of temporomandibular disorders: concepts and controversies. The Journal of prosthetic dentistry, 1997. 77(5): p. 510-522.
4) LeResche, L., Epidemiology of temporomandibular disorders: implications for the investigation of etiologic factors. Critical Reviews in Oral Biology & Medicine, 1997. 8(3): p. 291-305.
5) Manfredini, D., et al., Research diagnostic criteria for temporomandibular disorders:
a systematic review of axis I epidemiologic findings. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 2011. 112(4): p. 453-462.
6) Greene, C.S., The etiology of temporomandibular disorders: implications for treatment. Journal of orofacial pain, 2001. 15(2): p. 93-105.
7) Suvinen, T., et al., Temporomandibular disorder subtypes according to self‐reported physical and psychosocial variables in female patients: a re‐evaluation. Journal of oral rehabilitation, 2005. 32(3): p. 166-173.
8) Proffit, W.R., et al., Contemporary Orthodontics-E-Book: Contemporary OrthodonticsE-Book. 2018: Elsevier Health Sciences.
9) McNamara Jr, J.A., Orthodontic treatment and temporomandibular disorders. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 1997. 83(1): p. 107-117.
10) Ricketts, R.M., Clinical implications of the temporomandibular joint. American Journal of Orthodontics, 1966. 52(6): p. 416-439.
11) Manfredini, D., et al., Temporomandibular joint disorders in patients with different facial morphology. A systematic review of the literature. Journal of Oral and Maxillofacial Surgery, 2016. 74(1): p. 29-46.
12) Lapter Varga, M., Orthodontic therapy and temporomandibular disorders. Rad Hrvatske akademije znanosti i umjetnosti. Medicinske znanosti, 2010(507= 34): p. 75-84.
13) Inger Egermark, L., T. Magnusson, and G.E. Carlsson, A 20-year follow-up of signs and symptoms of temporomandibular disorders and malocclusions in subjects with and without orthodontic treatment in childhood. The Angle Orthodontist, 2003. 73(2): p. 109-115.
14) Magnusson, T. and A.S. Guimarães, Is orthodontic treatment a risk factor for temporomandibular disorders? Dental Press Journal of Orthodontics, 2012. 17: p. 97103.
15) Manfredini, D., et al., Orthodontics is temporomandibular disorder–neutral. The Angle Orthodontist, 2016. 86(4): p. 649-654.
16) Leite, R.A., et al., Relationship between temporomandibular disorders and orthodontic treatment: a literature review. Dental press journal of orthodontics, 2013. 18: p. 150157.
17) Han, J.-W. and T.-W. Kim, Dentofacial changes of non-orthodontically treated female patients with TMJ disk displacement: a longitudinal cephalometric study. Korean Journal of Orthodontics, 2010. 40(6): p. 398-410.
18) Wishney, M., Potential risks of orthodontic therapy: a critical review and conceptual framework. Australian dental journal, 2017. 62: p. 86-96.
19) Schiffman, E., et al., Diagnostic criteria for temporomandibular disorders (DC/TMD) for clinical and research applications: recommendations of the International RDC/TMD Consortium Network and Orofacial Pain Special Interest Group. Journal of oral & facial pain and headache, 2014. 28(1): p. 6.
20) Manfredini, D. and L. Nardini, Current concepts on temporomandibular disorders. 2010: Quintessence Berlin.
21) Okeson, J., Management of temporomandibular disorders and occlusion. New York State Dental Journal, 2003. 69(7): p. 61.
22) Ferrillo, M., et al., Pain management and rehabilitation for central sensitization in temporomandibular disorders: a comprehensive review. International journal of molecular sciences, 2022. 23(20): p. 12164.
23) Lobbezoo, F., et al., Predictors for the development of temporomandibular disorders in scuba divers. Journal of Oral Rehabilitation, 2014. 41(8): p. 573-580.
24) Greene, C.S., G.D. Klasser, and J.B. Epstein, Revision of the American Association of Dental Research’s Science Information Statement about Temporomandibular Disorders. J Can Dent Assoc, 2010. 76: p. a115.
25) Suvinen, T.I., et al., Temporomandibular disorder subtypes according to self-reported physical and psychosocial variables in female patients: a re-evaluation. J Oral Rehabil, 2005. 32(3): p. 166-73.
26) Pullinger, A.G. and D.A. Seligman, Quantification and validation of predictive values of occlusal variables in temporomandibular disorders using a multifactorial analysis. The Journal of prosthetic dentistry, 2000. 83(1): p. 66-75.
27) Manfredini, D., et al., Prevalence of tinnitus in patients with different temporomandibular disorders symptoms. The international tinnitus journal, 2015. 19(2): p. 47-51.
28) Greene, C.S., G.D. Klasser, and J.B. Epstein, Revision of the American Association of Dental Research’s science information statement about temporomandibular disorders. J Can Dent Assoc, 2010. 76(76): p. a115.
29) McNamara Jr, J.A., D.A. Seligman, and J.P. Okeson, Occlusion, Orthodontic treatment, and temporomandibular disorders: a review. Journal of orofacial pain, 1995. 9(1).
30) Mohlin, B., et al., TMD in relation to malocclusion and orthodontic treatment: a systematic review. The Angle Orthodontist, 2007. 77(3): p. 542-548.
31) Proffit, W.R., et al., Contemporary Orthodontics, 6e: South Asia Edition-E-Book. 2019: Elsevier Health Sciences.
32) Greene, C.S., Relationship between occlusion and temporomandibular disorders: Implications for the orthodontist. American Journal of Orthodontics and Dentofacial Orthopedics, 2011. 139(1): p. 11.
33) Proffit, W.R., et al., Ortodoncia contemporánea. 2019: Elsevier Health Sciences.
34) Türp, J. and H. Schindler, The dental occlusion as a suspected cause for TMDs: epidemiological and etiological considerations. Journal of oral rehabilitation, 2012. 39(7): p. 502-512.
35) Luther, F., S. Layton, and F. McDonald, Orthodontics for treating temporomandibular joint (TMJ) disorders. Cochrane database of systematic reviews, 2010(7).
36) Schindler, H.J., J.C. Türp, and L. Eberhard, Occlusal Splints for Painful Craniomandibular Dysfunction. 2022: Quintessence Publishing.