Exploring the enigmatic link between occlusion and temporomandibular disorders: Best evidence consensus

Temporomandibular joint disorders (TMDs) are nonodontogenic conditions affecting the temporomandibular joint (TMJ), supporting tissues, and masticatory muscles. TMD is linked to occlusal interferences which can cause degenerative changes in the TMJ. TMD is also linked to occlusal characteristics, such as unilateral lingual cross bites and deep bites, and can be influenced by implant therapy, craniofacial morphology, and psychosocial factors. The aim of this document is to examine available data related to occlusal characteristics and form a consensus on each characteristic. The methodology involved an extensive review of in vivo studies on TMD and malocclusion, covering publications from 1990 to June 2024. Keywords and Mesh terms were used to search databases, focusing on occlusal schemes, interferences, vertical jaw relations, craniofacial morphology, and stress. The search yielded 253 citations, later refined to 117 relevant studies. Filtering for clinical trials, reviews, and meta analyses resulted in 30 pertinent articles. Manual searching of bibliographies and cross referencing identified additional studies, ensuring comprehensive coverage. All selected articles were critically reviewed for evidence. Dental occlusion issues are a top priority for dentists treating patients with TMD. A thorough analysis of the relationship between dental occlusion and TMD has to be examined by the clinician before starting treatment of TMD. Some dental practitioners overlook potential involvement of abnormal skeletal structure or TMJ disease as a causal factor of TMD. As TMD is a multilinked process, the clinician should be well aware of all the parameters. Future teaching on occlusal dental occlusion should be integrated for academic and clinical purpose, with a thorough TMJ examination mandatory before patient treatment, and any predisposing factors highlighted in the examination porforma.