Tsukiyama Y, Baba K, Clark G T
Faculty of Dental Science, Kyushu University, Fukuoka, Japan.
J Prosthet Dent. 2001 Jul;86(1):57-66. doi: 10.1067/mpr.2001.115399.
Occlusal adjustment therapy has been advocated as a treatment modality for temporomandibular disorders. In contrast to this position, a panel at the 1996 National Institute of Health technology assessment conference on TMD indicated that no clinical trials demonstrate that occlusal adjustment is superior to noninvasive therapies.
This article summarizes the published experimental studies on occlusal adjustments and temporomandibular disorders.
Eleven research experiments involving 413 subjects with either bruxism (n = 59), temporomandibular disorders (n = 219), headaches and temporomandibular disorders (n = 91), or chronic cervical pain (n = 40) were selected for critical review from the English dental literature.
Three experiments evaluated the relationship between occlusal adjustment and bruxism. Six experiments evaluated occlusal adjustment therapy as a treatment for patients with primary temporomandibular disorders. One experiment looked at occlusal adjustment effect on headache/temporomandibular disorder symptoms; another looked at its effect on chronic neck pain. Most of these experiments used a mock adjustment or a comparison treatment as the control condition in adults who had an existing nonacute general temporomandibular disorder. Overall, the data from these experiments did not demonstrate elevated therapeutic efficacy for occlusal adjustment over the control or the contrasting therapy.
The experimental evidence reviewed was neither convincing nor powerful enough to support the performance of occlusal therapy as a general method for treating a nonacute temporomandibular disorder, bruxism, or headache.
咬合调整疗法一直被倡导作为颞下颌关节紊乱病的一种治疗方式。与这一观点相反，在1996年国立卫生研究院颞下颌关节紊乱病技术评估会议上，一个专家小组指出，没有临床试验表明咬合调整优于非侵入性疗法。
本文总结了已发表的关于咬合调整与颞下颌关节紊乱病的实验研究。
从英文牙科文献中选取了11项研究实验进行严格审查，这些实验涉及413名患有磨牙症（n = 59）、颞下颌关节紊乱病（n = 219）、头痛与颞下颌关节紊乱病（n = 91）或慢性颈痛（n = 40）的受试者。
三项实验评估了咬合调整与磨牙症之间的关系。六项实验评估了咬合调整疗法对原发性颞下颌关节紊乱病患者的治疗效果。一项实验观察了咬合调整对头痛/颞下颌关节紊乱病症状的影响；另一项观察了其对慢性颈部疼痛的影响。这些实验大多采用模拟调整或对照治疗作为现有非急性一般性颞下颌关节紊乱病成年患者的对照条件。总体而言，这些实验数据并未表明咬合调整比对照或对比疗法具有更高的治疗效果。
所审查的实验证据既不令人信服，也不够有力，不足以支持将咬合调整疗法作为治疗非急性颞下颌关节紊乱病、磨牙症或头痛的常规方法。
