A multiple logistic regression analysis was used to compute the odds ratios for 11 common occlusal features for asymptomatic controls (n = 147) vs. five temporomandibular disorder groups: Disc Displacement with Reduction (n = 81), Disc Displacement without Reduction (n = 48), Osteoarthrosis with Disc Displacement History (n = 75), Primary Osteoarthrosis (n = 85), and Myalgia Only (n = 124). Features that did not contribute included: retruded contact position (RCP) to intercuspal position (ICP) occlusal slides < or = 2 mm, slide asymmetry, unilateral RCP contacts, deep overbite, minimal overjet, dental midline discrepancies, < or = 4 missing teeth, and maxillo-mandibular first molar relationship or cross-arch asymmetry. Groupings of a minimum of two to at most five occlusal variables contributed to the TMD patient groups. Significant increases in risk occurred selectively with anterior open bite (p < 0.01), unilateral maxillary lingual crossbite (p < 0.05 to p < 0.01), overjets > 6-7 mm (p < 0.05 to p < 0.01), > or > 5-6 missing posterior teeth (p < 0.05 to p < 0.01), and RCP-ICP slides > 2 mm (p < 0.05 to p < 0.01). While the contribution of occlusion to the disease groups was not zero, most of the variation in each disease population was not explained by occlusal parameters. Thus, occlusion cannot be considered the unique or dominant factor in defining TMD populations. Certain features such as anterior open bite in osteoarthrosis patients were considered to be a consequence of rather than etiological factors for the disorder.
Dental attrition severity in 222 young adults was assessed from dental casts as the sum of the most severe facet in each arch segment. The attrition scores were compared by age, gender, bruxism awareness, prior bite adjustment, orthodontic class, maxillomandibular relationship, and temporomandibular dysfunction symptoms. Awareness of bruxism was not associated with the wear scores and should not be used to define bruxist groups. Attrition scores did not differ significantly between age groups, indicating that notable attrition, when present, often occurs early. Men had higher attrition scores than women (p less than 0.01), despite fewer signs and symptoms. Dental attrition was not associated with the presence or absence of TMJ clicking, TMJ tenderness, or masticatory muscle tenderness. Class II division 2 males had laterotrusive attrition scores lower than those of Class III (p less than 0.05). Class III females had lower incisor attrition scores than did other Angle Classes (p less than 0.05). Discernible dental attrition in a non-patient population was not associated with signs and symptoms of temporomandibular disorders, nor with the occlusal factors studied. These results are compatible with the findings in other studies that point to bruxism as a centrally induced phenomenon common to all people and unrelated to local factors.
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