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Etiology of temporomandibular disorders with special focus on the role of occlusion

Review article
Authors Gunnar E Carlsson
Droukas Byron
Tzakis Michalis
Published in Odontostomatological Progress
Volume 65
Issue 2
Pages 180-203
ISSN 0029-8506
Publication year 2011
Published at Institute of Odontology
Pages 180-203
Language el
Keywords TMDs – Occlusion, pain, general health etiology, management
Subject categories Other odontology


The aim of this article was to present a systematic evidence –based review of literature related to the etiology of temporomandibular disorders (TMD). Since there is a scarcity of the highest level of evidence, randomized controlled studies (RCTs), on this topic, the best available knowledge of TMD etiology was mainly based on studies of lower level of evidence and some recent more or less systematic reviews. Accepting these limitations, the following conclusions have been drawn. TMDs comprise a number of disorders and conditionς in the orofacial region. It is therefore self-evident that the etiology is multifactorial. The comorbidity between TMD signs and symptoms and pain and disorders in other parts of the body has lately attracted much attention. Impaired general health and systemic diseases constitute important parts in the complex etiology of many TMD problems. The role of psychological and psychosocial factors in the TMD etiology have received great acceptance over the last few years. Recent research indicates that occlusion does not play a major role in the etiology of TMD. However, the long controversy regarding the role of occlusion in the pathogenesis of TMD has not yet been resolved. Several dentists, although acknowledging that its importance may be smaller than previously believed, still claim that occlusion cannot be completely ruled out as a possible contributing factor in the etiology of TMD. Even if the etiology of TMD is not fully known, successful management of most TMD patients is possible. The clinician should explain to the patient the probable nature of the condition and that most TMDs are benign and can be treated with simple methods with a good prognosis.

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