Effect of artificial occlusal interferences depends on previous experience of temporomandibular disorders

Abstract

Studies on artificial interferences in subjects with no temporomandibular (TMD) history have shown adaptation to the interference within a fairly short period of time. The role of occlusal factors in the etiology of TMD has therefore been questioned. The results might have been different, however, if subjects with a prior TMD history had been included in the study groups. To test this assumption in a randomized double-blind clinical set-up, we included healthy women without (n = 26) as well as with (n = 21) an earlier TMD history. Both groups were randomly divided into true and placebo interference groups. Artificial interferences were introduced in the true interference groups and simulated in the placebo groups. The subjects were followed for 2 weeks, after which the interferences were removed. The subjects without a TMD history showed fairly good adaptation to the interferences, but the subjects with a TMD history and true interferences showed a significant increase in clinical signs compared to the other groups. We suggest that the etiological role of occlusal interferences in TMD may not have been correctly addressed in previous studies with artificial interferences and allow no conclusions as regards TMD etiology.

Occlusion, Orthodontic Treatment and Temporomandibular Disorders: Myths and Scientific Evidences

“…It should be kept in mind that this study was performed on healthy subjects (without present or passed history of TMD). It may be possible that patients suffering already from TMD react differently to an experimentally introduced occlusal interference due to a deficiency in their adaptation capacity (Le Bell et al 2002). This hypothesis is also based in the observation that TMD patients do keep their teeth in contact more often during daytime (Chen, 2005) and therefore are more likely to feel the interference as a disturbing factor (Le Cao et al 2009).…”

“…This hypothesis is also based in the observation that TMD patients do keep their teeth in contact more often during daytime (Chen, 2005) and therefore are more likely to feel the interference as a disturbing factor (Le Cao et al 2009). To test this assumption Le Bell et al (2002) performed a randomized double-blind clinical set-up that included healthy women without TMD as well as women with an earlier TMD history. Both groups were randomly divided into true and placebo interference groups.…”

The importance of masticatory functional analysis in the diagnostic finding and treatment planning for prosthodontic rehabilitation

“…This monitor is important in this case because the study by Abe et al, 38 showed that the position of the main occluding areas (functional cusp) in the FPDs tended to be less stable; and some experimental evidence that small acute changes might provoke transient symptoms in subjects with a history of past TMDs. 39 In temporary cementation of definitive denture, record and observe the masticatory function in 1 week (Table 3). It can be seen that ROM, overbite, overjet and VDO are stable, no deflection, no pain in muscles and TMJs palpation, no pai in load testing.…”

Temporomandibular Disorders and Orthodontic Treatment – A Review with a Reported Clinical Case

“…Le Bell et al (2002) found that artificial interferences do not stimulate the development of dysfunctional symptoms in healthy subjects, instead they adapt successfully to them. In patients whose medical histories show TMD interferences stimulate the recurrence of stronger symptoms.…”