Literature Review

1. JEFFERY P. OKESON

2. PRESENTED BY:
Dr. HIRENKUMAR RANA
CO-AUTHOR:
Dr. SHRUTI MEHTA

3. Costen syndrome
TMJ dysfunction syndrome
TM pain-dysfunction syndrome
functional TMJ disturbances
occlusomandibular disturbance
craniomandibular disorders
TM disorders
temporomandibular disorders, or TM disorders
*Griffiths RH: Report of the President’s Conference on examination, diagnosis and
management of temporomandibular disorders. J Am Dent Assoc 106:75-77, 1983.

4. *Greene CS. Managing the care of patients with temporomandibular disorders: a new
guideline for care. J Am Dent Assoc 2010;141:1086-8.

5. THE ASYMPTOMATIC INDIVIDUAL
OCCLUSAL FACTORS
Trauma
Deep pain input
Parafunction
NORMAL
TMJ
Emotional stress
TMD

6. *Ballegaard V, Thede-Schmidt-Hansen P, Svensson P, Jensen R. Are headache and
temporomandibular disorders related? A blinded study. Cephalalgia 2008;28:832-41.

7. Angle’s malocclusions
cross bites occlusal interferences in retruded
contact position (RCP) & balancing sides
interferences slide between RCP and intercuspal
position (ICP) presence of crown and bridge with
premature contact extensive overjet

8. find information about the presence or
absence of an association

9. OCCLUSAL PARAMETERS
AND TMD
(1961-2017)
DEFINED CRITERIA EMPLOYED IN SEARCH OF
ARTICLES FROM SEARCH ENGINES LIKE PubMed,
Google Scholar, Embase, Cocharane library, Google
search (from year 1961-2017) using keywords like
‘tempormandibular disorders’, ‘temporomandibular
joint tenderness, ‘functional disturbances of
masticatory system’, ‘craniomandibular disorders’,
‘occlusal parameters’, ‘occlusion’, ‘occlusal
interferences’, ‘occlusal factors’, etc.
TO BE CONT…

10. FOR FINDING SPECIFIC ARTICLES, TOPIC WERE
SELECTED AS ‘association’, ‘relationship’, ‘influence’,
etc.
34 REFERENCES
TITLE AND ABSTRACT REVIEW
TO BE CONT…

11. TITLE AND ABSTRACT REVIEW
19 ARTICLES EXCLUDED
•4 review literature articles
•15 articles excluded because
of lack or unclear description
of sample method,
randomization etc., and
different outcome of interest
(e.g., tooth loss, dentures)
15 RELEVANT ARTICLES SELECTED FOR REVIEW

12. AUTHOR
No. OF
SUBJECT
No. OF
WOMEN
/MEN
AGE
(yr)
POPULATION
RELATIONSHIP
BETWEEN
OCCLUSION
AND TMD
TYPE OF OCCLUSAL
PARAMETER RELATED
Solberg , 19721 58 40/18
18-
30
Causacian
patients and
nonpatients
controls
Yes
Deflective RCP, centric
slides
Graham et al., 19822 123 15/108
21 -
42
Random
sample of
dental
students
No None
Bush, 19853
298 56/242
22-
37
Dental
students No None
Droukas et al., 19854 50 37/13
16-
40
Mandibular
dysfunction
patients
No None
Seligman et al., 19885 222 102/120
19-
41
Dental and
dental
hygiene
students
Yes
Class II Div 2, Lack of
RCP-ICP slide,
asymmetric slide
Kirveskari et al.,
19896
97 -
18-
20
Random
sample of
children
Yes
Unilateral RCP, RCP-ICP
slide

13. AUTHOR
No. OF
SUBJECT
No. OF
WOME
N/MEN
AGE
(yr)
POPULATION
RELATIONSHIP
BETWEEN
OCCLUSION
AND TMD
TYPE OF OCCLUSAL
PARAMETER RELATED
Al Hadi, 19937 600
189/31
1
-
Dental
students Yes
Group function, occlusal
interferenes, overjet > 6
mm
Pullinger et al., 19938 560
403/15
7
12-80
TMD patients
divided into 5
groups and
asymptomatic
controls
Yes
Unilateral lingual
crossbite, > 4 missing
posteriors, RCP-ICP slide
>4 mm, anterior open
bite, overjet >5 mm
Seligman and
Pullinger, 20009
171 171/0
Mean
35
Female
patients with
intracapsular
TMD and
asymptomatic
controls
Yes
Anterior open bite,
crossbite, anterior
attrition, RCP-ICP slide
length, overjet
John et al., 200210 274 191/83 13-76
TMD patients
and controls No
None (incisal tooth
wear)
Celic et al., 200211 230 0/230 19-28
Non patient
population Yes
malocclusion traits,
interferences in RCP,
midline discrepancy ≥ 2
mm, ≤ 10 contacts,
balancing interferences,
overjet ≥ 5 mm

14. AUTHOR
No. OF
SUBJECT
No. OF
WOME
N/MEN
AGE
(yr)
POPULATION
RELATIONSHIP
BETWEEN
OCCLUSION
AND TMD
TYPE OF OCCLUSAL
PARAMETER RELATED
Pergamalian et al.,
200312
100 84/16 18-60 TMD patients No None (wear facets)
Schierz et al., 200713 646
341
/305
35-44
German-
speaking
population
No
None (anterior tooth
wear)
Troeltzsch et al.,
201114
1031
595
/436
Mean
49.6
Private
practice
population
Yes RCP-ICP slide > 3 mm
Costa et al., 201215 200 152/48 10-70
Patients
divided into
TMD group
and control
group
Yes
posterior crossbite ,
overjet > 5 mm,
balancing side
interferences

15. 9 ARTICLES
6 ARTICLES

16. 15 epidemiologic population as well as
clinical subject-based studies

17. 9 of these studies found positive relationship
between occlusal factors and TMD symptoms,
whereas 6 studies did not find such relationship.
NO SIMPLE CAUSE-AND-EFFECT RELATIONSHIP
EXIST*
*Okeson JP. Management of tempormandibular disorders and occlusion,2013, Missouri,
Elsevier.

19. *McNamara JA Jr, Seligman DS, Okeson JP: Occlusion, orthodontic treatment, and
temporomandibular disorders: a review, J Orofac Pain 9:73-90, 1995.

20. the etiology of TMD is multifactorial
*Barbosa SA, Filho CR, Fonseca RB, Soares CJ, Neves FD & Neto AJ: The role of
occlusion and occlusal adjustment on temporomandibular dysfunction. Braz J Oral
Sci,2004, 3(11),589-94.
†Gesch D, Bernhardt O & Kirbschus A. Association of malocclusion and functional
occlusion with temporomandibular disorders (TMD) in adults: A systematic review of
population-based studies. Quintessence Int 2004:35:211-221.

21. sound understanding of the precise etiology
population-based clinical
patient population-based studies
adequate methodologic
quality
sufficient sample size (power)
multivariately analyzed
adjusted to confounders

22. 1. Solberg, W. K., Flint, R. T., & Brantner, J. P. (1972). Temporomandibular
joint pain and dysfunction: A clinical study of emotional and occlusal
components. Journal of Prosthetic Dentistry, 28(4), 412-22.
2. Graham, M. M., Buxbaum, J., & Staling, L. H. (1982). A study of occlusal
relationships and the incidence of myofacial pain. Journal of Prosthetic
Dentistry, 47(5), 549-55.
3. Bush, F. M. (1985). Malocclusion, Masticatory Muscle, and
Temporomandibular Joint Tenderness. Journal of Dental Research,
64(2), 129-33.
4. Droukas, B., Lindee, C., & Carlsson, G. E. (1985). Occlusion and
mandibular dysfunction: A clinical study of patients referred for
functional disturbances of the masticatory system. Journal of Prosthetic
Dentistry, 53(3), 402-6.
5. Seligman, D. A., Pullinger, A. G., & Solberg, W. K. (1988).
Temporomandibular disorders. Part III: Occlusal and articular factors
associated with muscle tenderness. Journal of Prosthetic Dentistry,
59(4), 483-9.

23. 6. Kirveskari, P., Alanen, P., & Jamsa, T. (1989). Association between
craniomandibular disorders and occlusal interferences. Journal of
Prosthetic Dentistry, 62(1), 66-9.
7. L. Abd Al-Hadi. (1993). Prevalence of temporomandibular disorders in
relation to some occlusal parameters. Journal of Prosthetic Dentistry,
70(4), 345-50.
8. A.G. PULLINGER, D.A. SELIGMAN, & J.A. GORNBEIN. (1993). A Multiple
Logistic Regression Analysis of the Risk and Relative Odds of
Temporomandibular Disorders as a Function of Common Occlusal
Features. Journal of Dental Research, 72(6):968-79.
9. Pullinger, A. G., & Seligman, D. A. (2000). Quantification and validation
of predictive values of occlusal variables in temporomandibular
disorders using a multifactorial analysis. Journal of Prosthetic Dentistry,
83(1), 66-75.
10. John, M. T., Frank, H., Lobbezoo, F., Drangsholt, M., & Dette, K. E.
(2002). No association between incisal tooth wear and
temporomandibular disorders. Journal of Prosthetic Dentistry,
87(2),197-203.

24. 11. Celic, R., Jerolimov, V., & Panduric, J. (2002). A Study of the Influence of
Occlusal Factors and Parafunctional Habits on the Prevalence of Signs
and Symptoms of TMD. International Journal of Prosthodontics, 15(1),
43-8.
12. Pergamalian, A., Rudy, T. E., Zaki, H. S., & Greco, C. M. (2003). The
association between wear facets, bruxism, and severity of facial pain in
patients with temporomandibular disorders. Journal of Prosthetic
Dentistry, 90(2), 194-200.
13. Schierz, O., John, M. T., Schroeder, E., & Lobbezoo, F. (2007). Association
between anterior tooth wear and temporomandibular disorder pain in a
German population. Journal of Prosthetic Dentistry, 97(5), 305-9.
14. Troeltzsch, M., Troeltzsch, M., Cronin, R. J., Brodine, A. H.,
Frankenberger, R., & Messlinger, K. (2011). Prevalence and association
of headaches, temporomandibular joint disorders, and occlusal
interferences. Journal of Prosthetic Dentistry, 105(6), 410-7.
15. Costa, M. D., Froes Jr, G. R. & Santos, C. N. (2012). Evaluation of occlusal
factors in patients with temporomandibular joint disorder. Dental Press
Journal of Orthodontics, 17(6), 61-8.