Aim: There is an inadvertent alteration of the occlusal surface after dental treatment. However, research concerning the effect of these iatrogenic disturbances on the temporomandibular joint (TMJ) is scarce. Hence, the present study aimed to investigate the relationship between sudden iatrogenic occlusal disturbance and its effect on the myogenous temporomandibular disorder (TMD).
Materials and methods: A cross-sectional observational study was conducted among 30 female subjects aged 18 years to 38 years who received treatment (direct and indirect restorations altering the occlusal surfaces of teeth, and oral prophylaxis) in the students’ clinics at the College of Dentistry Jazan University. The preoperative assessment included a patient interview, a baseline occlusal record, and bite force analysis. All the assessments were repeated 2 weeks after the treatment. Descriptive statistics were calculated.
Results: As there was no change observed in bite force as well as occlusal disturbances in the control group, no comparative tests could be applied. The treatment-induced occlusal disturbances were observed in 80% of the participants. The mean change in occlusal force on the treated teeth was found to be 5.6 ± 1.1 Newtons. None of the patients reported any symptoms related to pain or restriction in function in the TMJ.
Conclusion: No relation was observed between the abrupt changes in the occlusal force due to dental treatment and the development of the myogenous TMD.
Clinical significance: Iatrogenic occlusal interferences may cause/exacerbate TMDs; hence, extreme caution should be exercised by the clinicians to avoid causing harm to the patients.
McNeill C, Mohl ND, Rugh JD, et al. Temporomandibular disorders: diagnosis, management, education, and research. J Am Dent Assoc 1990;120:253, 255, 257, 10.14219/jada.archive.1990.0049.
Gesch D, Bernhardt O, Alte D, et al. Prevalence of signs and symptoms of temporomandibular disorders in an urban and rural German population: results of a population-based Study of Health in Pomerania. Quintessence Int 2004;35:143–150.
Wright EF. Manual of temporomandibular disorders. Ames (IA): Wiley; 2005. pp. 60–111.
Xie Q, Li X, Xu X. The difficult relationship between occlusal interferences and temporomandibular disorder–insights from animal and human experimental studies. J Oral Rehabil 2013;40(4): 279–295. DOI: 10.1111/joor.12034.
LeResche L. Epidemiology of temporomandibular disorders: implications for the investigation of etiologic factors. Crit Rev Oral Bio Med 1997 Jul;8(3):291–305. DOI: 10.1177/10454411970080030401.
Suvinen TI, Reade PC, Hanes KR, et al. Temporomandibular disorder subtypes according to self-reported physical and psychosocial variables in female patients: a re-evaluation. J Oral Rehabil 2005;32:166–173. DOI: 10.1111/j.1365-2842.2004.01432.x.
Hagag G, Yoshida K, Miura H. Occlusion, prosthodontic treatment, and temporomandibular disorders: a review. J Med Dent Sci 2000;47(1):61–66.
Bengt O. Prosthodontics, Principles and Management Strategies. London: Mosby-Wolfe; 1996. p. 97.
Kogawa EM, Calderon PS, Lauris JR, et al. Evaluation of maximal bite force in temporomandibular disorders patients. J Oral Rehabil 2006; 33(8):559–565. DOI: 10.1111/j.1365-2842.2006.01619.x.
Garner LD, Kotwal NS. Correlation study of incisive biting forces with age, sex, and anterior occlusion. J Dent Res 1973;52:698–702. DOI: 10.1177/00220345730520041001.
Agerberg G, Sandstorm R. Frequency of occlusal interference: a clinical study in teenagers and young adults. J Prosthet Dent 1988;59:212–217. DOI: 10.1016/0022-3913(88)90017-0.
Solberg WK, Woo MW, Houston JB. Prevalence of mandibular dysfunction in young adults. J Am Dent Assoc 1979;98:25–34. DOI: 10.14219/jada.archive.1979.0008.
Ingervall B, Mohlin B, Thilander B. Prevalence of symptoms of functional disturbances of the masticatory system in Swedish men. J Oral Rehabil 1980;7:185–197. DOI: 10.1111/j.1365-2842.1980. tb00435.x.
Schaerer P, Stallard RE, Zander HA. Occlusal interferences and mastication: an electromyographies study. J Prosthet Dent 1967;17:438–449. DOI: 10.1016/0022-3913(67)90141-2.
DeBoever J. Experimental occlusal balancing contact interferences and muscle activity. An electromyographies study with permanently applied electrodes. Parodontologie 1969;23:59–69.
Sheikholeslam A, Riise C. Influence of experimental interfering occlusal contacts on the activity of the anterior temporal and masseter muscles during submaximal and maximal bite in the intercuspal position. J Oral Rehabil 1983;10:207–214. DOI: 10.1111/j.1365-2842.1983.tb00114.x.
Rugh JD, Barghi N, Drago CJ. Experimental occlusal discrepancies and nocturnal bruxism. J Prosthet Dent 1984;51:548–553. DOI: 10.1016/0022-3913(84)90312-3.
Magnusson T, Enbom L. Signs and symptoms of mandibular dysfunction after introduction of experimental balancing-side interference. Acta Odontol Scand 1984;42:129–135. DOI: 10.3109/00016358408993863.
Kamp T, Hannerz H, Storm P. Ten-year follow up study of signs and symptoms of craniomandibular disorders in adults with intact and restored dentitions. J Oral Rehabil 1996;23:416–423. DOI: 10.1111/j.1365-2842.1996.tb00873.x.
Michelotti A, Iodice G. The role of orthodontics in temporomandibular disorders. J Oral Rehabil 2010;37(6):411–429. DOI: 10.1111/j.1365-2842.2010.02087.x.