Journal of Prosthetic Dentistry
Volume 90, Issue 4 , Pages 373-384 , October 2003

Occlusion: Reflections on science and clinical reality

Presented at the Annual Meeting of the American Equilibration Society. Chicago: February, 2000.

  • Major M Ash, BS, DDS, MS, MD hc

      Affiliations

    • Department of Periodontics, Prevention and Geriatrics, School of Dentistry, University of Michigan, Ann Arbor, Mich, USA
    • Corresponding Author InformationReprint requests to:Dr Major M. Ash, Dean's Office-Administration, School of Dentistry, University of Michigan, Ann Arbor, MI 48109-1078, USA, Fax: (734) 995-1961

References 

  1. Antczak-Bouckoms AA. Epidemiology of research for temporomandibular disorders. J Orofac Pain. 1995;9:226–234
  2. Clark GT, Tsukiyama Y, Baba K, Watanabe T. Sixty-eight years of experimental occlusal interference studies (what have we learned?). J Prosthet Dent. 1999;82:704–713
  3. Ash MM. Philosophy of occlusion (past and present). Dent Clin North Am. 1995;39:233–255
  4. Forssell H, Kalso E, Koskela P, Vehmanen R, Puukka P, Alanen P. Occlusal treatments in temporomandibular disorders (a qualitative systematic review of randomized controlled trials). Pain. 1999;83:549–560
  5. Johnston LE Jr. A systems analysis of occlusion. In: McNamara JA, Carlson DS, Ribbens KA, editors. Developmental aspects of temporomandibular joint disorders. University of Michigan: Craniofacial Publications; 1985. p. 191-205
  6. Sackett DL, Rosenberg WM, Gray JA, Haynes RB, Richardson WS. Evidence based medicine (what it is and what it isn't). BMJ. 1996;312:71–72
  7. Goodman SN. Toward evidence-based medical statistics. 1 (the P value fallacy). Ann Intern Med. 1999;130:995–1004
  8. Feinstein AR, Horwitz RI. Problems in the “evidence” of “evidence-based” medicine. Am J Med. 1997;103:529–535
  9. Tonelli MR. The philosophical limits of evidence-based medicine. Acad Med. 1998;73:1234–1240
  10. Altman DG, Gardner MJ. Confidence intervals for research evaluation. Br J Obstet Gynaecol. 1992;99:40–41
  11. Berry G. Statistical significance and confidence intervals. Med J Aust. 1986;144:618–619
  12. Simon R. Confidence intervals for reporting results of clinical trials. Ann Intern Med. 1986;105:429–435
  13. Goodman SN. Toward evidence-based medical statistics. 2 (the Bayes factor). Ann Intern Med. 1999;130:1005–1013
  14. Davidoff F. Standing statistics right side up. Ann Intern Med. 1999;130:1019–1021
  15. Lilford RJ, Braunholtz D. The statistical basis of public policy (a paradigm shift is overdue). BMJ. 1996;313:603–607
  16. Moore DS. Bayes for beginners? Some reasons to hesitate. American Statistician. 1997;51:254–261
  17. Carlin BP, Louis TA. Bayes and empirical Bayes methods for data analysis. 2nd ed. Boca Raton (FL): Chapman and Hall/CRC; 2000; p. xiii
  18. Pogue J, Yusuf S. Overcoming the limitations of current meta-analysis of randomised controlled trials. Lancet. 1998;351:47–52
  19. Normand SL. Meta-analysis (formulating, evaluating, combining, and reporting). Stat Med. 1999;18:321–359
  20. Cook DJ, Sackett DL, Spitzer WO. Methodologic guidelines for systematic reviews of randomized controlled trials in health care from the Potsdam Consultation on Meta-analysis. J Clin Epidemiol. 1995;48:167–171
  21. Jakobsen JR. A survey of statistical methods used in dental literature. J Dent Educ. 1999;63:350–352
  22. US Department of Human Services, Public Health Service, Agency for Health Care Policy and Research. Acute pain management: operative or medical procedures and trauma (AHCPR 920038). Rockville (MD): Agency for Health Care Policy and Research Publications; 1992
  23. Sackett DL, Strauss SE, Richardson WS, Rosenberg W, Haynes RB. Evidence-based medicine. How to practice and teach EBM. 2nd ed. Edinburgh: Churchill Livingstone; 2000; p. 13-27
  24. Sharpe D. Of apples and oranges, file drawers and garbage (why validity issues in meta-analysis will not go away). Clin Psychol Rev. 1997;17:881–901
  25. Sackett DL, Deeks JJ, Altman DG. Down with odds ratios!. Evid Based Med. 1996;1:164
  26. Everitt BS. The Cambridge dictionary of statistics. 2nd ed. Cambridge, UK: Cambridge University Press; 2002; p. 281
  27. Kirveskari P, Alanen P. Odds ratio in the estimation of the significance of occlusal factors in craniomandibular disorders. J Oral Rehabil. 1995;22:581–584
  28. Alanen P. Remarks on the use of some basic epidemiological concepts in dentistry. Proc Finn Dent Soc. 1991;87:209–215
  29. Pullinger AG, Seligman DA, Gornbein JA. A multiple logistic regression analysis of the risk of relative odds of temporomandibular disorders as a function of common occlusal features. J Dent Res. 1993;72:968–979
  30. Jacob RF, Carr AB. Hierarchy of research design used to categorize the “strength of evidence” in answering clinical dental questions. J Prosthet Dent. 2000;83:137–152
  31. Pocock SJ. Clinical trials (a practical approach). New York: John Wiley; 1984; p. xii, 266
  32. Friedman LM, Furberg CD, Demets DL. Fundamentals of clinical trials. 3rd ed. New York: Springer-Verlag; 1998; p. 1-12
  33. Kalish LA, Begg CB. Treatment allocation methods in clinical trials (a review). Stat Med. 1985;4:129–144
  34. Hadorn DC, Baker D, Hodges JS, Hicks N. Rating the quality of evidence for clinical practice guidelines. J Clin Epidemiol. 1996;48:749–754
  35. Moses LE. Measuring effects without randomized trials? Options, problems, challenges. Med Care. 1995;33:AS8–14
  36. McQuay HJ, Moore RA. An evidence-based resource for pain relief. New York: Oxford University Press; 1998; p. 12
  37. McKee M, Britton A, Black N, McPherson K, Sanderson C, Bain C. Methods in health services research. Interpreting the evidence (choosing between randomised and non-randomised studies). BMJ. 1999;319:312–315
  38. Forssell H, Kirveskari P, Kangasniemi P. Changes in headache after treatment of mandibular dysfunction. Cephalalgia. 1985;5:229–236
  39. Karppinen K, Eklund S, Suoninen E, Eskelin M, Kirveskari P. Adjustment of dental occlusion in treatment of chronic cervicobrachial pain and headache. J Oral Rehabil. 1999;26:715–721
  40. Kirveskari P, Jamsa T, Alanen P. Occlusal adjustment and the incidence of demand for temporomandibular disorder treatment. J Prosthet Dent. 1998;79:433–438
  41. Burgett FG, Ramfjord SP, Nissle RR, Morrison EC, Charbeneau TD, Caffesse RG. A randomized trial of occlusal adjustment in the treatment of periodontitis patients. J Clin Periodontol. 1992;19:381–387
  42. Anonymous. Management of temporomandibular disorders. National Institutes of Health Technology Assessment Conference Statement. J Am Dent Assoc 1996;127:1595-606
  43. De Boever JA, Carlsson GE, Klineberg IJ. Need for occlusal therapy and prosthodontic treatment in the management of temporomandibular disorders. Part I. Occlusal interferences and occlusal adjustment. J Oral Rehabil. 2000;27:367–379
  44. Clark GT. Etiologic theory and the prevention of temporomandibular disorders. Adv Dent Res. 1991;5:60–66
  45. Pullinger AG, Seligman DA, Gornbein JA. A multiple logistic analysis of the risk and relative odds of temporomandibular disorders as a function of common occlusal features. J Dent Res. 1993;72:968–979
  46. Pullinger AG, Seligman DA. Quantification and validation of predictive values of occlusal variables in temporomandibular disorders using a multifactorial analysis. J Prosthet Dent. 2000;83:66–75
  47. Glaros AG, Glass EG, McLaughlin L. Knowledge and beliefs of dentists regarding temporomandibular disorders and chronic pain. J Orofac Pain. 1994;8:216–222
  48. Hughes JR, Krahn D. Blindness and validity of the double-blind procedure. J Clin Psychopharmacol. 1985;5:138–142
  49. Edwards SJ, Lilford RJ, Hewison J. The ethics of randomised controlled trials from the perspectives of patients, the public, and healthcare professionals. BMJ. 1998;317:1209–1212
  50. Torgerson DJ, Roberts C. Understanding controlled trials. Randomisation methods (concealment). BMJ. 1999;319:375–376
  51. Sackett DL. Evidence-based medicine. Spine. 1998;23:1085–1086
  52. Jaeschke R, Guyatt GH, Sackett DL. Users' guide to the medical literature. III. How to use an article about a diagnostic test. A. Are the results of the study valid?. Evidence-Based Medicine Working Group. JAMA. 1994;271:389–391
  53. Jaeschke R, Guyatt GH, Sackett DL. Users' guide to the medical literature. III. How to use and article about a diagnostic test. B. What are the results and will they help me in caring for my patients?. Evidence-Based Medicine Working Group. JAMA. 1994;271:703–707
  54. Black N. What observational studies can offer decision makers. Horm Res. 1999;51:44–49
  55. Zucker DR, Schmidt CH, McIntosh MW, D'Agostino RB, Selker HP, Lau J. Combining single patient (N-of-1) trials to estimate population treatment effects and to evaluate individual patient responses to treatment. J Clin Epidemiol. 1997;50:401–410
  56. Niederman R. Evidence-based dentistry (what is it, and what does it have to do with practice? The methods of evidence-based dentistry). Quintessence Int. 1998;29:811–817
  57. Cook DJ, Mulrow CD, Haynes RB. Systematic reviews (synthesis of best evidence for clinical decisions). Ann Intern Med. 1997;126:376–380
  58. Bero L, Rennie D. The Cochrane Collaboration. Preparing, maintaining, and disseminating systematic reviews on the effects of health care. JAMA. 1995;274:1935–1938
  59. Mulrow CD, Oxman D. Cochrane collaboration handbook. In: Cochrane Library Issue 4. Oxford: Update Software, 1997
  60. Tang JL, Liu JL. Misleading funnel plot for detection of bias in meta-analysis. J Clin Epidemiol. 2000;53:477–484
  61. Horwitz RI. Complexity and contradiction in clinical trial research. Am J Med. 1987;82:498–510
  62. Borenstein M. Meta analysis: study database analyzer. St. Paul (MN): Assessment System Corp; 2000
  63. NHS Centre for Reviews and Dissemination. Undertaking systematic reviews of research on effectiveness. CRD's guidance for those carrying out or commissioning reviews (CRD Report 4). York: The University of York, 1996
  64. The Cochrane Library 2000. A collection of databases published on CD-ROM and the internet, Available at: http://www.update-software.com/cochrane/cochrane-frame.html. Updated quarterly
  65. Oxman AD, Guyatt GH. Validation of an index of the quality of review articles. J Clin Epidemiol. 1991;44:1271–1278
  66. Hunt DL, McKibbon KA. Locating and appraising systematic reviews. In:  Mulrow CD,  Cook D editor. Systematic reviews (synthesis of best evidence for health care decisions). Philadelphia: American College of Physicians; 1998;p. 13–22
  67. Murrell KD. Communications (technology transfer in the developed world). Vet Parasitol. 1996;64:107–120
  68. Haynes RB, Hayward RS, Lomas J. Bridges between health care research evidence and clinical practice. J Am Med Inform Assoc. 1995;2:342–350
  69. Horowitz AM. The public's oral health (the gaps between what we know and what we practice). Adv Dent Res. 1995;9:91–95
  70. Greer AL. The state of the art versus the state of the science. The diffusion of new medical technologies into practice. Int J Technol Assess Health Care. 1988;4:5–26
  71. Jadad AR, McQuay HJ. Meta-analysis to evaluate analgesic interventions (a systematic qualitative review of their methodology). J Clin Epidemiol. 1996;49:235–243
  72. Evidence-Based Medicine Working Group . Evidence-based medicine. A new approach to teaching the practice of medicine. JAMA. 1992;268:2420–2425
  73. Pincus T, Stein CM. ACR 20 (clinical or statistical significance?). Arthritis Rheum. 1999;42:1572–1576
  74. Valachovic RW. Making science clinically relevant. J Dent Educ. 1997;61:434–436
  75. Haffajee AD, Socransky SS. Microbial etiological agents of destructive periodontal diseases. Periodontol. 2000;1994:5
  76. Kennedy JE. Impediments to change and their resolution in clinical practice. J Dent Educ. 1998;62:882–889
  77. Dowie J. ‘Evidence-based,’ ‘cost-effective’ and ‘preference-driven’ medicine (decision analysis based medical decision making is the prerequisite). J Health Serv Res Policy. 1996;1:104–113
  78. Feine JS, Lund JP. An assessment of the efficacy of physical therapy and physical modalities for control of chronic musculoskeletal pain. Pain. 1997;71:5–23
  79. Elander G, Hermeren G. Placebo effect and randomized clinical trials. Theoretical Medicine. 1995;16:171–182
  80. Dao TT, Lavigne GJ. Oral splints (the crutches for temporomandibular disorders and bruxism?). Crit Rev Oral Biol Med. 1998;9:345–361
  81. Feine JS, Dufresne E, Boudrias P, Lund JP. Outcome assessment of implant-supported prostheses. J Prosthet Dent. 1998;79:575–579
  82. Sutton AJ, Jones DR, Abrams KR, Sheldon TA, Song F. Systematic reviews and meta-analysis (a structured review of the methodological literature). J Health Serv Res Policy. 1999;4:49–55
  83. Dickersin K, Scherer R, Lefebvre C. Identifying studies for systematic reviews. BMJ. 1994;309:1286–1291
  84. Dickersin K, Berlin JA. Meta-analysis (state-of-the-science). Epidemiol Rev. 1992;14:154–176
  85. Alanen PJ, Kirveskari PK. Disorders in TMJ research. Cranio. 1990;4:223–227
  86. Rice A, Liddell A. Determinants of positive and negative attitudes toward dentistry. J Can Dent Assoc. 1998;64:213–218
  87. Naylor CD. Grey zones of clinical practice (some limits to evidence-based medicine). Lancet. 1995;345:840–842
  88. Cannavina CD, Cannavina G, Walsh TF. Effects of evidence-based treatment and consent on professional autonomy. Br Dent J. 2000;188:302–306
  89. Johnston LE Jr. Commentary on: Harrison JE, Ashby D. Orthodontic treatments for posterior cross-bites (Cochrane Review). In: Cochrane Library, issue 1, 1999. Oxford Update Software. Evidence-Based Dentistry 2000;2:19
  90. Schulz KF, Chalmers I, Hayes RJ, Altman DG. Empirical evidence of bias. Dimensions of methodological quality associated with estimates of treatment effects in controlled trials. JAMA. 1995;273:408–412
  91. Schulz K. Subverting randomization in controlled trials. JAMA. 1995;274:1456–1458
  92. Easterbrook PJ, Berlin JA, Gopalan R, Matthews DR. Publication bias in clinical research. Lancet. 1991;337:867–872
  93. In:  Mulrow CD,  Cook D editor. Systematic reviews. Synthesis of best evidence for health care decisions. Philadelphia: American College of Physicians; 1998; p. ix
  94. Barnes J, Stein A, Rosenberg W. Evidence-based medicine and the evaluation of mental health services (methodological issues and future directions). Arch Dis Child. 1999;80:280–285
  95. Guyatt GH, Juniper EF, Walter SD, Griffith LE, Goldstein RS. Interpreting treatment effects in randomised trials. BMJ. 1998;316:690–693
  96. Raphael K, Marbach JJ. Evidence-based care of musculoskeletal facial pain (implications for the clinical science of dentistry). J Am Dent Assoc. 1997;128:73–79
  97. Durand-Zaleski I, Conlin C, Blum-Boisgard C. An attempt to save money by using mandatory practice guidelines in France. BMJ. 1997;315:943–946
  98. Ermann D, Richmond J. Managed care arrangements (barriers to cost saving potential). Med Care Rev. 1994;51:125–148
  99. Sutherland SE. The building blocks of evidence-based dentistry. J Can Dent Assoc. 2000;66:241–244
  100. Chambers DW. Some issues in problem-based learning. J Dent Educ. 1995;59:567–571
  101. Kay E, Nuttall N. Clinical decision making—an art or a science? Part II (making sense of treatment decisions). Br Dent J. 1995;178:113–116
  102. Kay E, Nuttall N. Clinical decision making—an art or a science? Part III (to treat or not to treat?). Br Dent J. 1995;178:153–155
  103. Paraphrase of a quotation by Sidney Burwell, Dean of Harvard Medical School. Quote in Pickering GW. Br Med J 1956;2:113-6
  104. Tedesco LA. Issues in dental curriculum and change. J Dent Educ. 1995;59:97–147
  105. US Public Health Service. Healthy People 2000 Progress Report on Oral Health. Washington, DC: US Department of Health and Human Services, 1995
  106. Hodges DJ, Mangum FL, Ward MT. Relationship between gap width and recurrent dental caries beneath occlusal margins of amalgam restorations. Community Dent Oral Epidemiol. 1995;23:200–204
  107. Welch HG, Lurie JD. Teaching evidence-based medicine (caveats and challenges). Acad Med. 2000;75:235–240
  108. The Glossary of Prosthodontic Terms. J Prosthet Dent 1999;81:39-110
  109. Murray MC, Brunton PA, Osborne-Smith K, Wilson NH. Canine risers (indications and techniques for their use). Eur J Prosthodont Restor Dent. 2001;9:137–140
  110. Christensen LV, Rassouli NM. Experimental occlusal interferences. Part I. a review. J Oral Rehabil. 1995;22:515–520
  111. Shiau YY, Ash MM. Immediate and delayed effects of working interferences on EMG and jaw movements. In:  Van Steenberghe D,  De Laat A editor. Electromyography of jaw reflexes in man. Leuven, Belgium: Leuven University Press; 1989;p. 311–326
  112. Karlsson S, Cho SA, Carlsson GE. Changes in mandibular masticatory movements after insertion of nonworking-side interference. Cranio. 1992;6:177–183
  113. Ramfjord SP, Hiniker JJ. Distal displacement of the mandible in adult rhesus monkeys. J Prosthet Dent. 1966;16:491–502
  114. Svanberg GK, King GJ, Gibbs CH. Occlusal considerations in periodontology. Periodontol 2000. 1995;9:106–117
  115. Burgett FG, Ramfjord SP, Nissle RR, Morrison EC, Charbeneau TD, Caffesse RG. A randomized trial of occlusal adjustment in the treatment of periodontitis patients. J Clin Periodontol. 1992;19:381–387
  116. Forssell H, Kirveskari P, Kangasniemi P. Effect of occlusal adjustment on mandibular dysfunction. A double-blind study. Acta Odontol Scand. 1986;44:63–69
  117. In:  Okeson JP editors. Orofacial pain: guidelines for assessment, diagnosis, and management. Chicago: Quintessence Publishing; 1996;p. 116
  118. Lavigne GJ, Rompre PH, Montplaisir JY. Sleep bruxism (validity of clinical research diagnostic criteria in a controlled polysomnographic study). J Dent Res. 1996;75:546–552
  119. Susser MW. Causal thinking in the health sciences (concepts and strategies of epidemiology). New York: Oxford University Press; 1973; p. 70
  120. Kieser JA, Groeneveld HT. Relationship between juvenile bruxing and craniomandibular dysfunction. J Oral Rehabil. 1998;25:662–665
  121. Magnusson T, Carlsson GE, Egermark I. Changes in subjective symptoms of craniomandibular disorders in children and adolescents during a 10-year period. J Orofac Pain. 1993;7:76–82
  122. Allen JD, Rivera-Morales WC, Zwemer JD. Occurrence of temporomandibular disorder symptoms in healthy young adults with and without evidence of bruxism. Cranio. 1990;8:312–318

PII: S0022-3913(03)00453-0

doi: 10.1016/S0022-3913(03)00453-0

Journal of Prosthetic Dentistry
Volume 90, Issue 4 , Pages 373-384 , October 2003