Stone J Caitlin, Hannah Andrew, Nagar Nathan
Department of Oral Medicine and Oral Pathology, and.
Department of Oral Surgery, Dundee Dental Hospital, Dundee, Scotland.
Evid Based Dent. 2017 Oct 27;18(3):86-87. doi: 10.1038/sj.ebd.6401258.
Data sourcesMedline, Scopus and Google Scholar.Study selectionTwo reviewers selected studies independently. English language clinical studies assessing the association between temporomandibular disorders (TMD) and features of dental occlusion were considered.Data extraction and synthesisStudy quality was assessed based on the Newcastle-Ottawa Scale (NOS) and a narrative synthesis was presented.ResultsIn all 25 studies (17 case-control, eight comparative) were included. Overall there was a high variability between occlusal features and TMD diagnosis. Findings were consistent with a lack of clinically relevant association between TMD and dental occlusion. Only two studies were associated with TMD in the majority (≥50%) of single variable analyses in patient populations. Only mediotrusive interferences are associated with TMD in the majority of multiple variable analyses.ConclusionsThe findings support the absence of a disease-specific association, there is no ground to hypothesise a major role for dental occlusion in the pathophysiology of TMDs. Dental clinicians are thus encouraged to move forward and abandon the old-fashioned gnathological paradig.
数据来源
医学文献数据库（Medline）、Scopus和谷歌学术。
研究选择
两名评审员独立选择研究。纳入评估颞下颌关节紊乱病（TMD）与牙合特征之间关联的英文临床研究。
数据提取与综合分析
基于纽卡斯尔-渥太华量表（NOS）评估研究质量，并进行叙述性综合分析。
结果
共纳入25项研究（17项病例对照研究，8项比较研究）。总体而言，牙合特征与TMD诊断之间存在高度变异性。研究结果与TMD和牙合之间缺乏临床相关关联一致。在患者群体的大多数单变量分析中，只有两项研究与TMD相关（≥50%）。在大多数多变量分析中，只有正中侧方干扰与TMD相关。
结论
研究结果支持不存在疾病特异性关联，没有理由假设牙合在TMD病理生理学中起主要作用。因此，鼓励牙科临床医生向前迈进，摒弃过时的口腔颌学范式。
