Temporomandibular symptoms and occlusion: a review of the literature & the concept.

The role of occlusal factors in the etiology of temporomandibular disorders (TMD) is reviewed. The rediscovery of TMD by J.B. Costen in 1934 and the origin of this concept are historically linked. Difficulties in scientifically studying TMD are addressed. TMD lacks specific indicators (signs and symptoms), are episodic and respond to placebos. Clinical success with specific literature (experimental, epidemiological and clinical studies) reviewed fails to support the concept that occlusal factors play a significant role in the etiology of TMD. The remodeling capacity of the temporomandibular joint demonstrates that the joint can accommodate and adapt to various occlusal conditions.