Temporomandibular Disorders in Orthodontics: Review on Current Evidence and Protocols

Abstract

Temporomandibular disorders (TMDs) are the most common cause of pain of non-dental origin with uncertain etiology involving several direct, indirect, precipitating, initiating and perpetuating factors. Over the years studies focusing on long term orthodontic procedures and its impact on temporomandibular joints were carried to evaluate the relationship between occlusal factors, orthodontic treatment and TMDs. Thus it is important to rule out other causes of Temporo-mandibular joint (TMJ) pain before considering occlusal disturbances as potential etiological factor. The present brief review was carried to outline the possible association between orthodontic procedures, treatment and occurrence of TMDs. The present assessment revealed there is little supportive evidence currently available to establish orthodontic treatment as a substantial predisposing factor for TMDs. Several studies hypothesized that TMJ disturbances by muscular hyperfunction, increased masticatory muscle activity and occlusal interferences resulted in pain and dysfunction at the joint. However it was also postulated that orthodontic treatment combined with orthognathic surgery significantly reduced pain on patients who show TMDs pre-operatively. It must be noted that vast majority of patients with TMDs, show favorable prognosis that subsides with appropriate treatment strategies.