Orthodontics as a therapeutic option for temporomandibular disorders: a systematic review

Abstract

OBJECTIVE: Orthodontics as an option for treatment and prevention of Temporomandibular Disorders (TMD) is a topic that has generated discussion over time. While an occlusion current defends Orthodontics as an alternative to treatment, another current defends more conservative and reversible treatments. The objective of this study, through a systematic literature review, was to analyze the relationship between Orthodontics and TMD, checking the effects of orthodontic therapy in treatment and prevention of TMD. METHODS: Survey in research bases: MEDLINE, Cochrane, EMBASE, Pubmed, Lilacs and BBO, between the years of 1966 and May 2009, with focus in randomized clinical trials, non-randomized prospective longitudinal studies, systematic reviews and meta-analysis was performed. RESULTS: After application of the inclusion criteria 11 articles were selected, 9 which were non-randomized prospective longitudinal studies, 1 randomized clinical trial and 1 systematic review. CONCLUSIONS: According to the literature, there is a lack of specific studies that evaluated Orthodontics as an option for treatment and prevention of TMD. Thus the data conclude that there is no significant scientific evidences that orthodontic treatment treats or prevents TMD

Relationship between orthodontics and temporomandibular disorders

“…The same conclusion is detected by several other recent reviews 23,[44][45][46][47][48] . Nevertheless, the correct occlusion and the muscle equilibration, which are achieved with the orthodontic treatment, may prevent or reduce the risk factors of the TMDs [49][50][51][52] .…”

“…A comprehensive medical and dental history and a thorough physical examination of these patients in combination with the appropriate radiographic examinations of the TMJ, constitute the most comprehensive diagnostic evaluation of the TMDs 23,44,64,65 , especially in the case of adult patients 66 .…”

Perception of the relationship between TMD and orthodontic treatment among orthodontists

“…Several studies have pointed out that occlusion is important for the development of TMD, 10 and that orthodontic treatment has some influence over the signs and symptoms of TMD. 11 Moreover, extensive reviews and clinical studies do not indicate that orthodontic treatment predisposes 12 - 15 or decreases the risk of developing future TMD. 16 - 20 Furthermore, orthodontic treatment has not been indicated as initial therapy for patients with TMD.…”

Evaluation of Symptoms of Temporomandibular Disorders in Orthodontic Appliance Users

“…These findings suggest that the orthodontic treatment with the use of fixed appliances is not an etiological factor related to TMD symptoms. The literature describes that TMD has multifactorial etiology and unpredictable nature, highlighting that malocclusion or use of orthodontic appliances does not configure triggering factors for these disorders (Greene et al, 1999;Conti et al, 2007;Machado et al, 2010).…”