Abstract
Statement of problem
The presence of temporomandibular disorders (TMDs) and/or bruxism signs and symptoms
may present multifaceted concerns for the prosthodontist.
Purpose
The purpose of this systematic review was to evaluate the relationship between prosthetic
rehabilitation and TMDs and bruxism.
Material and methods
Three research questions were identified based on different clinical scenarios. Should
prosthodontics be used to treat TMD and/or bruxism? Can prosthodontics cause TMDs
and/or bruxism? How can prosthodontics be performed (for prosthetic reasons) in patients
with TMDs and/or bruxism? A systematic search in the PubMed database was performed
to identify all randomized clinical trials (RCTs) comparing the effectiveness of prosthodontics
with that of other treatments in the management of TMDs and/or bruxism (question 1);
clinical trials reporting the onset of TMDs and/or bruxism after the execution of
prosthetic treatments in healthy individuals (question 2); and RCTs comparing the
effectiveness of different prosthodontics strategies in the management of the prosthetic
needs in patients with TMDs and/or bruxism (question 3).
Results
No clinical trials of the reviewed topics were found, and a comprehensive review relying
on the best available evidence was provided. Bruxism is not linearly related to TMDs,
and both of these conditions are multifaceted. Based on the diminished causal role
of dental occlusion, prosthetic rehabilitation cannot be recommended as a treatment
for the 2 conditions. In theory, they may increase the demand for adaptation beyond
the stomatognathic system’s tolerability. No evidence-based guidelines were available
for the best strategy for managing prosthetic needs in patients with TMDs and/or bruxism.
Conclusions
This systematic review of publications revealed an absence of RCTs on the various
topics concerning the relationship between TMD and bruxism and prosthodontics. Based
on the best available evidence, prosthetic changes in dental occlusion are not yet
acceptable as strategies for solving TMD symptoms or helping an individual stop bruxism.
Clinicians should take care when performing irreversible occlusal changes in healthy
individuals and in patients with TMD and/or bruxism.
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Article info
Publication history
Published online: November 08, 2016
Footnotes
This article is based on D.M.'s presentation to the American Academy of Fixed Prosthodontics, Chicago, Ill. February 2016.
Identification
Copyright
© 2016 by the Editorial Council for The Journal of Prosthetic Dentistry.
